154 results match your criteria Imaging in Wegener Granulomatosis Thoracic


COVID-19 and eosinophilic granulomatosis with polyangiitis or COVID-19 mimicking eosinophilic granulomatosis with polyangiitis?

Rheumatol Int 2021 May 25. Epub 2021 May 25.

Division of Rheumatology, Department of Internal Medicine, Ankara City Hospital, Ankara, 06100, Turkey.

Coronavirus disease 2019 (COVID-19) and eosinophilic granulomatosis with polyangiitis (EGPA) share similarities in clinical, imaging findings and may present with respiratory distress. Differentiating a new-onset EGPA from COVID-19 during the current pandemic is a diagnostic challenge, particularly if other EGPA symptoms are overlooked. Here in this study we reviewed the literature regarding EGPA patients with COVID-19 and patients who diagnosed with EGPA or suffered an EGPA flare mimicking COVID-19. Read More

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Granulomatosis With Polyangiitis (Wegener's Granulomatosis) Complicated by Pericarditis: Our Experience of Two Cases and Comparative Review of Literature.

CASE (Phila) 2021 Apr 26;5(2):126-136. Epub 2021 Jan 26.

Center for the Diagnosis and Treatment of Pericardial Diseases, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.

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Granulomatosis with polyangiitis in a patient with a thoracic vertebral lesion: a case report.

Mod Rheumatol Case Rep 2021 Apr 22:1-7. Epub 2021 Apr 22.

Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan.

Granulomatosis with polyangiitis is a systemic, small vessel vasculitis associated with the anti-neutrophil cytoplasmic antibody. We herein report a case of granulomatosis with polyangiitis with paravertebral lesions. A 69-year-old man presented to our hospital with fever, back pain, and myalgia. Read More

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Lessons of the month: ANCA-associated vasculitis - granulomatosis with polyangiitis: 'the great mimic'.

Clin Med (Lond) 2021 03;21(2):e231-e233

North Bristol NHS Trust, Bristol, UK and University of Bristol, Bristol, UK.

We describe the case of a 61-year-old woman who presented with progressive respiratory symptoms and imaging demonstrating multiple opacities in the right lung with hilar and mediastinal lymphadenopathy suggestive of multifocal adenocarcinoma. Subsequent biopsies were consistent with focal changes of organising pneumonia (OP) and no evidence of malignancy. She was treated with steroids for cryptogenic OP with limited response. Read More

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Lesson of the month: Severe granulomatosis with polyangiitis (GPA): a diagnostic challenge during the COVID-19 pandemic.

Clin Med (Lond) 2021 Jan;21(1):79-80

Great Western Hospital, Swindon, UK.

We present the case of a 71-year-old woman with bilateral pneumonia who continued to deteriorate despite multiple courses of antibiotics. When dexamethasone was added to cover the possibility of COVID-19 pneumonia, she rapidly improved. Subsequently, she was found to have a strongly positive PR3 anti-nuclear cytoplasmic antibody (ANCA) and clinical features consistent with granulomatosis with polyangiitis (GPA) with upper respiratory tract and renal involvement. Read More

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January 2021

Thoracic Manifestation of Granulomatosis with Polyangiitis: A Case Report.

Adv Exp Med Biol 2021 ;1324:35-40

Division of Oncology and Palliative Care, Department of Clinical Nursing, Faculty of Health Science, Wrocław Medical University, Wrocław, Poland.

Granulomatosis with polyangiitis (GPA) is an antineutrophil cytoplasmic antibody (ANCA)-associated disorder with necrotic vasculitis of small- and medium-size arteries and veins. In the literature, there are many case reports of patients with GPA of different, sometimes unusual, clinical manifestations. In this paper, we present difficulties that accompanied the process of diagnosing GPA in a 54-year-old symptomatic patient who was. Read More

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Pathological entities that may affect the lungs and the myocardium. Evaluation with chest CT and cardiac MR.

Clin Imaging 2021 Feb 31;70:124-135. Epub 2020 Oct 31.

University of Toronto - Sunnybrook Health Sciences Centre, Department of Medical Imaging, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada. Electronic address:

Certain entities may simultaneously involve the lungs and the myocardium. Knowing their cardiac and thoracic manifestations enhances the understanding of those conditions and increases awareness and suspicion for possible concurrent cardiothoracic involvement. Entities that can present with pulmonary and myocardial involvement include infiltrative diseases like sarcoidosis and amyloidosis, eosinophil-associated conditions including eosinophilic granulomatosis with polyangiitis (EGPA) and hypereosinophilic syndrome (HES), connective tissue diseases such as systemic sclerosis (SSc) and lupus erythematosus and genetic disorders like Fabry disease (FD). Read More

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February 2021

Thoracic imaging finding of rheumatic diseases.

J Thorac Dis 2020 Sep;12(9):5110-5118

Department of Radiology, City of Hope National Medical Center, Duarte, CA 91010, USA.

In the era of Precision Medicine, diagnostic imaging plays a key role in initial diagnosis and treatment response assessment in thoracic manifestation of various rheumatic disorders; resulting in increased dependency on imaging for treatment planning. Chest radiographs serve as a good initial screening tool for assessment of emergent and urgent thoracic conditions, e.g. Read More

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September 2020

Severe Unilateral Lung Parenchymal Opacities: A Unique Presentation of Granulomatosis with Polyangiitis.

Am J Respir Crit Care Med 2020 10;202(8):e117-e118

Department of Respiratory Medicine, Copenhagen University Hospital, Bispebjerg, Denmark.

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October 2020

Idiopathic subglottic stenosis: a review.

J Thorac Dis 2020 Mar;12(3):1100-1111

Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA.

Idiopathic subglottic stenosis (iSGS) is a fibrotic disease of unclear etiology that produces obstruction of the central airway in the anatomic region under the glottis. The diagnosis of this entity is difficult, usually delayed and confounded with other common respiratory diseases. No apparent etiology is identified even after a comprehensive workup that includes a complete history, physical examination, pulmonary function testing, auto-antibodies, imaging studies, and endoscopic procedures. Read More

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Imaging Approach to Cavitary Lung Disease.

Ann Am Thorac Soc 2020 03;17(3):367-371

Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, California; and.

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Unusual manifestations of giant cell arteritis and granulomatosis with polyangiitis.

Immunol Med 2019 Jun 30;42(2):94-98. Epub 2019 Aug 30.

Division of Metabolism and Biosystemic Science, Department of Medicine, Asahikawa Medical University , Hokkaido , Japan.

Giant cell arteritis (GCA) is a type of large vessel vasculitis, and it involves the aorta, large vessels and terminal branches of the external carotid artery, especially the temporal artery. Temporal artery biopsy is a simple tool for the diagnosis of vasculitis, however, the histopathological findings do not always differentiate between the small-vessel vasculitis and GCA. We report the case of 72-year-old male who initially had a clinical diagnosis of GCA, then in the course of treatment, diagnostic histopathological approach revealed the necrotizing vasculitis with bronchocentric granulomatosis in the inflammatory nodule of the lung. Read More

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Non-small Cell Lung Cancer Treated by an Anti-programmed Cell Death-1 Antibody without a Flare-up of Preexisting Granulomatosis with Polyangiitis.

Intern Med 2019 Nov 10;58(21):3129-3132. Epub 2019 Jul 10.

Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan.

The safety and efficacy of anti-programmed cell death-1 (PD-1) antibodies in patients with granulomatosis with polyangiitis (GPA) still remain unclear. An 83-year-old man with GPA that was well controlled with immunosuppressive therapy was diagnosed with a postoperative recurrence of non-small cell lung cancer (NSCLC). Because the programmed cell death ligand 1 (PD-L1) tumor proportion score was 90%, pembrolizumab was administered. Read More

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November 2019

Lung-limited granulomatosis with polyangiitis: managed without immunosuppression.

QJM 2019 Sep;112(9):685-688

Respiratory Medicine, Imperial College Healthcare Trust at Hammersmith Hospital, National Heart and Lung Institute Imperial College, Ducane Road, London W12 0NN, UK.

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September 2019

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) masquerading as acute ST-elevation myocardial infarction with complete resolution after immunosuppressive therapy: a case report.

Eur Heart J Case Rep 2018 Sep 21;2(3):yty075. Epub 2018 Sep 21.

Department of Cardiology, King's College Hospital, Denmark Hill, London, UK.

Background: Eosinophilic granulomatosis with polyangiitis (EGPA, formerly known as Churg-Strauss syndrome) is a rare autoimmune condition characterized by inflammation of small- and medium-sized blood vessels, which usually presents with systemic vasculitis preceded by airway allergic hypersensitivity.

Case Summary: Here, we report a highly unusual case of acute ST-elevation myocardial infarction in a young and fit man with no cardiovascular risk factors. His emergency coronary angiography revealed disproportionately severe widespread coronary artery disease. Read More

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September 2018

Granulomatosis with polyangiitis in a patient with biopsy-proven IgG4-related pulmonary disease and coincident small cell lung cancer.

BMJ Case Rep 2019 Mar 14;12(3). Epub 2019 Mar 14.

Rheumatology (111R), Minneapolis VA HCS, Minneapolis, Minnesota, USA.

Granulomatosis with polyangiitis (GPA) was diagnosed in a patient with a 16-month history of IgG4-related lung disease that spontaneously became asymptomatic. Cytoplasmic antineutrophil cytoplasmic antibody (ANCA) was positive at the time of diagnosis of IgG4-related disease (IgG4-RD), but there was no vasculitis or kidney disease. Sixteen months later he developed rapidly progressive glomerulonephritis that responded to cyclophosphamide treatment. Read More

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Eosinophilic angiocentric fibrosis : a sino-orbital masquerader.

BMJ Case Rep 2018 Aug 9;2018. Epub 2018 Aug 9.

Ophthalmology, Orlando VA Medical Center, Orlando, Florida, USA.

A 58-year-old Caucasian male presented with left periorbital oedema extending to the nasal area for 1 year along with nasal discharge for 1 month. Lab work was significant for positive cytoplasmic antineutrophil cytoplasmic antibodies. CT scan showed solid mass along the nasal soft tissue with bony nasal destruction. Read More

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Eosinophilic granulomatosis with polyangiitis and laryngeal involvement: review of the literature and a cross-sectional prospective experience.

J Laryngol Otol 2018 Jul 11;132(7):619-623. Epub 2018 Jun 11.

Rheumatology Unit,University of Pisa,Italy.

Background: Eosinophilic granulomatosis with polyangiitis and granulomatosis with polyangiitis show variable otorhinolaryngological involvement. Up to 14 per cent of granulomatosis with polyangiitis patients have subglottis involvement; little is known about the laryngeal involvement in eosinophilic granulomatosis with polyangiitis.

Method: A literature review was conducted, together with a prospective cross-sectional analysis of 43 eosinophilic granulomatosis with polyangiitis patients. Read More

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Comparison of findings on thoracic computed tomography with the severity and duration of bronchial asthma in patients with eosinophilic granulomatosis with polyangiitis.

Respir Med 2018 06 9;139:101-105. Epub 2018 May 9.

Department of Respiratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo, Japan. Electronic address:

Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic necrotizing vasculitis with eosinophilia. EGPA can occur in patients with comorbid bronchial asthma (BA) and other pulmonary diseases. However, because of its rarity, there are few reports on thoracic computed tomography (CT) findings in patients with EGPA, especially in relation to comorbid BA. Read More

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A rare case of mitral valve dissection and aortic-left ventricular tunnel associated with possible autoimmune vasculitis.

Echocardiography 2018 06 14;35(6):893-894. Epub 2018 May 14.

Department of Echocardiography, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China.

We report a very rare case of mitral valve dissection and aortic-left ventricular tunnel caused by possible autoimmune vasculitis. We suspected Behcet's disease in this patient. There was no obvious clinical evidence of infective endocarditis. Read More

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Granulomatosis With Polyangiitis Involving the Ascending Aorta.

Ann Thorac Surg 2018 07 9;106(1):e11-e13. Epub 2018 Mar 9.

Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. Electronic address:

A 58-year-old man visited the emergency department with vague anterior chest discomfort. From the computed tomographic findings, our initial suspicion was intramural hematoma in the ascending aorta. After a comprehensive discussion with relevant departments, emergent operation was planned. Read More

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Cavitary Lung Diseases: A Clinical-Radiologic Algorithmic Approach.

Chest 2018 06 6;153(6):1443-1465. Epub 2018 Mar 6.

Pulmonary Division, Lenox Hill Hospital Northwell Health, New York, NY. Electronic address:

Cavities occasionally are encountered on thoracic images. Their differential diagnosis is large and includes, among others, various infections, autoimmune conditions, and primary and metastatic malignancies. We offer an algorithmic approach to their evaluation by initially excluding mimics of cavities and then broadly classifying them according to the duration of clinical symptoms and radiographic abnormalities. Read More

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Breast granulomatosis with polyangiitis mimicking breast cancer.

Pathologica 2017 Dec;109(4):405-407

Pathology Unit, Azienda USL Valle d'Aosta, Hospital "Parini", Aosta, Italy.

Inflammatory lesions of the breast encompass primary reactive processes and local manifestation of systemic diseases. They are very rare and they are generally treated without resort to biopsy. Nevertheless they could be clinically challenge mimicking malignant process and needing surgery to reach a correct diagnosis. Read More

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December 2017

Eosinophilic granulomatosis with polyangiitis without respiratory symptoms or asthma in an adolescent: case report and literature review.

Rheumatol Int 2018 Apr 30;38(4):697-703. Epub 2017 Nov 30.

Department of Pediatric Rheumatology, Pamukkale University School of Medicine, Pamukkale, Denizli, Turkey.

Eosinophilic granulomatosis with polyangiitis (EGPA), also known as Churg-Strauss syndrome, is a systemic necrotizing vasculitis of the small and medium vessels. It is primarily associated with respiratory conditions such as asthma and sinusitis as well as eosinophilia, neuropathy, pulmonary infiltrates, and vasculitis. EGPA is extremely rare in the pediatric age group, and respiratory system disorders are usually predominant in EGPA patients. Read More

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Seronegative granulomatosis with polyangiitis presenting with multiple cranial nerve palsies.

Neuropathology 2018 Apr 14;38(2):192-197. Epub 2017 Nov 14.

Department of Pathology, Seoul National University Hospital, College of Medicine, Seoul, Republic of Korea.

Granulomatosis with polyangiitis (GPA), previously known as Wegener's granulomatosis (WG), is a rare systemic disease characterized by necrotizing granulomas and vasculitis that usually presents in the respiratory tract and renal system. Here, we report a case of anti-neutrophil cytoplasmic antibody (ANCA)-negative GPA with diagnostic difficulties. Neurologic involvement in GPA is not uncommon, with up to 50% of patients manifesting with neurologic defects; however, it is usually a late event. Read More

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Pulmonary Involvement in Antineutrophil Cytoplasmic Antibodies (ANCA)-associated Vasculitis: The Influence of ANCA Subtype.

J Rheumatol 2017 Oct 1;44(10):1458-1467. Epub 2017 Aug 1.

From the Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Vasculitis and Lupus Clinic, and Department of Radiology, and Department of Respiratory Medicine, Addenbrooke's Hospital, Cambridge, UK.

Objective: To describe pulmonary involvement at time of diagnosis in antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV), as defined by computed tomography (CT).

Methods: Patients with thoracic CT performed on or after the onset of AAV (n = 140; 75 women; granulomatosis with polyangiitis, n = 79; microscopic polyangiitis MPA, n = 61) followed at a tertiary referral center vasculitis clinic were studied. Radiological patterns of pulmonary involvement were evaluated from the CT studies using a predefined protocol, and compared to proteinase 3 (PR3)-ANCA and myeloperoxidase (MPO)-ANCA specificity. Read More

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October 2017

Pseudotumoral form of granulomatosis with polyangiitis.

Pan Afr Med J 2017;26:173. Epub 2017 Mar 27.

Internal Medicine Department, Mohammed V Military Teaching Hospital, Rabat, Morocco.

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February 2018

Pulmonary-Limited Granulomatosis with Polyangiitis Coexisting with Mixed Connective Tissue Disease.

Tohoku J Exp Med 2017 06;242(2):109-114

Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine.

Granulomatosis with polyangiitis (GPA) is a systemic disease characterized by necrotizing, granulomatous vasculitis of the upper and lower respiratory tracts and glomerulonephritis, and is classified as a classical or limited form. The classical form of GPA demonstrates the involvement of the upper respiratory tract, sinuses, lungs and kidneys, whereas the limited form is characterized by the lack of the renal involvement with female predominance. On the other hand, mixed connective tissue disease (MCTD) shows the clinical and laboratorial features of systemic lupus erythematosus, systemic sclerosis and polymyositis, along with high titers of anti-ribonucleoprotein antibodies and is characterized by good response to corticosteroid therapy and favorable prognosis. Read More

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Bilateral acute angle-closure glaucoma as a first presentation of granulomatosis with polyangiitis (Wegener's).

Arq Bras Oftalmol 2016 Sep-Oct;79(5):336-338

Department of Ophthalmology, School of Medicine, Gaziantep University, Gaziantep, Turkey.

We report a case of bilateral acute angle-closure glaucoma in a patient with undiagnosed granulomatosis with polyangiitis (Wegener's). A 59-year-old man presented with a severe headache, ocular pain, blurred vision, shortness of breath, and mild fever. Clinical examination revealed conjunctival chemosis, corneal edema, and shallow anterior chambers. Read More

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