Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
권호 표지

A Case of Wegener's Granulomatosis that Presented as a Single Lung Mass

단일 폐종괴로 발견된 Wegener 육아종증 1예

  • Oh, In Jae (Department of Internal Medicine, Chunnam National University, Medical School) ;
  • Jeong, Jong Pil (Department of Internal Medicine, Chunnam National University, Medical School) ;
  • Kim, Soo Ok (Department of Internal Medicine, Chunnam National University, Medical School) ;
  • Son, Jun Gwang (Department of Internal Medicine, Chunnam National University, Medical School) ;
  • Ban, Hee Jung (Department of Internal Medicine, Chunnam National University, Medical School) ;
  • Lim, Jung Hwan (Department of Internal Medicine, Chunnam National University, Medical School) ;
  • Cho, Gye Jung (Department of Internal Medicine, Chunnam National University, Medical School) ;
  • Ju, Jin Young (Department of Internal Medicine, Chunnam National University, Medical School) ;
  • Kim, Kyu Sik (Department of Internal Medicine, Chunnam National University, Medical School) ;
  • Kim, Yu Il (Department of Internal Medicine, Chunnam National University, Medical School) ;
  • Lim, Sung Chul (Department of Internal Medicine, Chunnam National University, Medical School) ;
  • Kim, Young Chul (Department of Internal Medicine, Chunnam National University, Medical School)
  • 오인재 (전남대학교 의과대학 내과학교실) ;
  • 정종필 (전남대학교 의과대학 내과학교실) ;
  • 김수옥 (전남대학교 의과대학 내과학교실) ;
  • 손준광 (전남대학교 의과대학 내과학교실) ;
  • 반희정 (전남대학교 의과대학 내과학교실) ;
  • 임정환 (전남대학교 의과대학 내과학교실) ;
  • 조계중 (전남대학교 의과대학 내과학교실) ;
  • 주진영 (전남대학교 의과대학 내과학교실) ;
  • 김규식 (전남대학교 의과대학 내과학교실) ;
  • 김유일 (전남대학교 의과대학 내과학교실) ;
  • 임성철 (전남대학교 의과대학 내과학교실) ;
  • 김영철 (전남대학교 의과대학 내과학교실)
  • Received : 2007.04.05
  • Accepted : 2007.06.11
  • Published : 2007.07.30
Download PDF
⟨ Previous Next ⟩

Abstract

Wegener's granulomatosis is a disease with an unknown etiology that is characterized by necrotizing granulomatous vasculitis involving the upper and lower respiratory tract and the kidneys. The typical pulmonary findings are bilaterally involved multiple variable sized nodules. We report a case of Wegener's granulomatosis that presented as a single lung mass. A male patient presented with a nasal obstruction, arthralgia, cough, and intermittent dyspnea. The chest radiograph showed a mass, approximately 4.5 cm in diameter, in the right lower lobe. Lung cancer or tuberculosis was initially considered. However, the clinical, laboratory and pathological findings of the mass indicated Wegener's granulomatosis. The patient was administered prednisolone and cyclophosphamide, and improved temporarily. Unfortunately, the immunocompromised patient expired as a result of respiratory failure with pneumonia.

저자 등은 단일 폐종괴로 발견되어 결핵이나 종양과의 감별이 쉽지 않아 개흉 조직검사를 통해 Wegener 육아종증을 진단 후 면역 억제 치료를 하였으나 폐렴 및 호흡부전이 발생한 증례를 경험하였기에 보고하는 바이다.

Keywords

References

  1. Hoffman GS, Kerr GS, Leavitt RY, Hallahan CW, Lebovics RS, Travis WD, et al. Wegener's granulomatosis: an analysis of 158 patients. Ann Intern Med 1992;116:488-98 https://doi.org/10.7326/0003-4819-116-1-88
  2. Nishino H, ThRemee RA, Rubino FA, Parisi JE. Wegener's granulomatosis associated with vasculitis of the temporal artery: report of five cases. Mayo Clin Proc 1993;68:115-21
  3. Cordier JF, Valeyre D, Guillevin L, Loire R, Brechot JM Pulmonary Wegener's granulomatosis. A clinical and imaging study of 77 cases. Chest 1990;97:906-12 https://doi.org/10.1378/chest.97.4.906
  4. Maguire R, Fauci AS, Doppman JL, Wolff SM Unusual radiographic features of Wegener's granulomatosis. Am J Roentgenol 1978;130:233-8 https://doi.org/10.2214/ajr.130.2.233
  5. Aberle DR, Gamsu G, Lynch D. Thoracic manifestations of Wegener granulomatosis: diagnosis and course. Radiology 1990;174:703-9 https://doi.org/10.1148/radiology.174.3.2305053
  6. Rao JK, Weinberger M, Oddone EZ, Allen NB, Landsman P, Feussner JR. The role of antineutrophil cytoplasmic antibody (c-ANCA) testing in the diagnosis of Wegener granulomatosis. A literature review and meta-analysis. Ann Intern Med 1995;123:925-32 https://doi.org/10.7326/0003-4819-123-12-199512150-00005
  7. Niles JL, Pan GL, Collins AB, Shannon T, Skates S, Fienberg R, et al. Antigen-specific radioimmunoassays for anti-neutrophil cytoplasmic antibodies in the diagnosis of rapidly progressive glomerulonephritis. J Am Soc Nephrol 1991;2:27-36
  8. Kallenberg CG, Brouwer E, Weening JJ, Tervaert JW. Anti-neutrophil cytoplasmic antibodies: current diagnostic and pathophysiological potential. Kidney Int 1994;46:1-15 https://doi.org/10.1038/ki.1994.239
  9. Weber MF, Andrassy K, Pullig O, Koderisch J, Netzer K Antineutrophil-cytoplasmic antibodies and antiglomerular basement membrane antibodies in Goodpasture's syndrome and in Wegener's granulomatosis. J Am Soc Nephrol 1992;2:1227-34
  10. Specks U, DeRemee RA. Granulomatous vasculitis. Wegener's granulomatosis and Churg-Strauss syndrome. Rheum Dis Clin North Am 1990;16:377-97
  11. Stokes TC, McCann BG, Rees RT, Sims EH, Harrison BD. Acute fulminating intrapulmonary hemorrhage in Wegener's granulomatosis. Thorax 1982;37:315-6 https://doi.org/10.1136/thx.37.4.315