Wegener’s Granulomatosis Presenting with Bilateral Excavated Nodules

Emna Braham, Hajer Racil, Houda Ben Rejeb, Moncef Hamdane, Abdellatif Chabou, Faouzi El Mezni

Department of Pathology, Abderrahmen Mami Hospital, Ariana, Tunisia.
Department of Pneumology, Abderrahmen Mami Hospital, Ariana, Tunisia.

DOI: 10.4236/ojpathology.2012.22006                

Abstract

Wegener’s granulomatosis (WG) is a systemic inflammatory disease whose histopathologic features often include necrosis, granuloma formation, and vasculitis of small-to-medium-sized vessels. We report a new case of Wegener’s granulomatosis occurring in a 41-year-old man who was admitted for respiratory symptoms, fever, asthenia, night sweats and weight loss since one month. Chest X-ray and computed tomography showed multiple bilateral pulmonary excavated lesions. A trransparietal lung biopsy was performed. Histological examination showed an area of necrosis, surrounded by a palisade of histiocytes. Some of the histiocytes were multinucleated and formed true granulomas within the wall of the adjacent pulmonary artery. Serology was strongly positive for ANCA. A diagnosis of Wegener granulomatosis was conducted and the patient was started on cyclophosphamide and methylprednisolone as an initial treatment, with a favorable evolution.

Keywords

Vasculitis; Wegener; Pathology; Lung; Granulomatous Inflammation

Conflicts of Interest

The authors declare no conflicts of interest.

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