PMC3920422_01
Initial high-resolution computed tomographic image demonstrating right lower lobe nodular, cavitary lung disease.
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Thoracic high-resolution computed tomography (HRCT) imaging revealed several nodules and thick-walled cavities predominantly in the right lung (Fig. 1).
Photomicrograph (10x) of histopathology specimen demonstrating necrotizing granulomatous inflammation with geographic necrosis, and vasculitis.
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Surgical lung biopsy revealed necrotizing granulomatous inflammation with geographic necrosis, vasculitis and lymphocytic pleuritis (Fig. 2) most compatible with an autoimmune-mediated vasculitis.
Follow-up high-resolution computed tomographic image demonstrating mild improvement in right lower lobe nodular, cavitary lung disease.
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A follow-up HRCT, reflecting three months of therapy with corticosteroids and methotrexate demonstrates that the pulmonary cavitary nodularity is gradually improving (Fig. 3).