PMC5733126_01
CT scan at first visit shows swelling of the mucosa in the bilateral ethmoid sinuses (a) along with a soft-tissue area occupying the right sphenoid sinus (b).
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CT scan revealed swelling of the mucosa in the bilateral ethmoid sinuses and soft-tissue filling in the right sphenoid sinus (Figures 1(a) and 1(b)).
During endoscopic sinus surgery, granulomatous mucosa is apparent in the right (a) and left (b) ethmoid sinuses.
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During ESS, easy bleeding and granulomatous mucosa in the bilateral ethmoid sinuses was seen and resected (Figures 2(a) and 2(b)).
Histopathological examination of the granulomatous mucosa from the ethmoid sinus shows significant necrotizing vasculitis (a) and granulomatous inflammation with multinucleated giant cells (b) (HE staining, x200). MT: middle turbinate.
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Histopathological examination of the mucosa revealed necrotizing vasculitis with multinucleated giant cells (Figures 3(a) and 3(b)).
CT scan 18 months after being diagnosed with GPA shows a lesion of the right sphenoid sinus eroding the bone of the clivus and thickening of the dura mater on axial (a) and sagittal (b) images (triangle).
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CT scan revealed a lesion of the right sphenoid sinus eroding the bone of the clivus and thickening of the dura mater (Figures 4(a) and 4(b)).
Imaging studies before immunosuppressive treatment (a-d) and 2 years after the initiation of the treatment (e-g). Gadolinium-enhanced T1-weighted MRI of the brain reveals thickening of enhanced dura mater extending from the cavernous sinus to the clivus on axial (a) and coronal (b) images (triangle). Narrowing at the C5 portion of the internal carotid artery (ICA) is apparent on axial (a) and coronal (b) MRI, MRA (c), and lateral cerebral angiography of the ICA (d) (arrow). Thickening of the dura mater and stenosis of the ICA improved on axial (e) and coronal (f) MRI and MRA (g).
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MRI of the brain showed thickening of the dura mater around the right cavernous sinus and clivus (Figures 5(a) and 5(b)). Magnetic resonance angiography (MRA) and cerebral angiography revealed narrowing at the C5 portion of the ICA (Figures 5(a)-5(d)). Brain MRI and MRA showed a reduction in the thickness of the dura mater and improved blood flow in the ICA (Figures 5(e)-5(g)).