PMC6008675_01
Chest radiograph and computed tomography (CT) of our patient with granulomatosis with polyangiitis. (a) Chest radiography demonstrating lung nodules. (b) CT of the chest showing lung nodules bilaterally. (c) CT of the abdomen showing a localized abdominal aortic aneurysm with a periaortic soft tissue mass. (d) CT of the abdomen after treatment. (e) CT of the left maxillary sinus.
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A computed tomography (CT) scan showed an aneurysm of the infrarenal aorta, with a diameter of 34 mm, and inflammation of the surrounding adipose tissue, nodular lesions of the bilateral lungs, and left maxillary sinusitis (Figure 1). All of the patient's symptoms and CT findings rapidly improved (Figure 1(d)), and the PR3-ANCA level promptly decreased to the normal range.
Histopathological findings of lung nodules from our patient with granulomatosis with polyangiitis. (a) Hematoxylin and eosin (H&E) staining (x40) of lung biopsy showing necrosis and inflammatory cell infiltration. (b) H&E staining (x100) of lung biopsy showing vascular occlusion and multinucleated giant cells. (c) Elastica van Gieson (EVG) staining (x40) of the lung showing destruction of the arterial medium. (d) EVG staining (x100) of lung biopsy showing vascular occlusion.
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The biopsy specimens demonstrated granulation tissue with necrosis and multinucleated giant cells (Figure 2).