Lesson of the week: Pulmonary Wegener's granulomatosis misdiagnosed as malignancy

Abstract

24 Rosler M, Anand R, Cicin-Sain A, Gauthier S, Agid Y, Dal-Bianco P, et al. Efficacy and safety of rivastigmine in patients with Alzheimer's disease: international randomised controlled trial. BMJ 1999;318:633-40. 25 Dawson-Hughs B, Harris SS, Krall EA, Dallal GE. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 1997;337:670-6. 26 Black DM, Cummings SR, Karpf DB et al. Randomised trial of effective alendronate on risk of fracture in women with existing vertebral fractures. Fracture intervention trial research group. Lancet 1996;348:1535-41. 27 Ensrud KE, Black DM, Polermo L, Bauer DC, Barrett-Connor E, Quandt SD, et al. Treatment with alendronate prevents fractures in women at highest risks. Results from the fracture intervention trial. Arch Intern Med 1997;157:2617-24. 28 Ettinger B, Black DM, Mitlak BH, Knickerbocker RK, Nickelson T, Genant HK, et al for the Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene. Results from a three-year randomised clinical trial. JAMA 1999;282:637-45. 29 Cummings SR, Eckert S, Krueger KA et al. The effect of raloxifene on risk of breast cancer in postmenopausal women. Results from the MORE randomised trial. JAMA 1999;

Thoracic manifestation of Wegener's granulomatosis: Computed tomography findings and analysis of misdiagnosis

“…WG is frequently misdiagnosed as tumor-like lesions, including metastatic tumors and bronchial lung cancer. WG presenting with multiple solid nodules has been misdiagnosed as metastatic tumor; however, CT scans differ from those of patients with metastatic tumors (41). Multiple solid nodules of metastatic tumors are always variable in size and are mainly distributed in the peripheral lung, whereas multiple solid nodules of WG typically present with irregular outlines combined with smooth edges, as well as irregular nodules.…”

Wegener's granulomatosis - another challenging case

“…As a result, it often took a long time to set the diagnosis, yet early diagnosis and treatment is important as progression of the disease can lead to permanent organ damage and can be life threatening. Early checking of C-ANCA and pr3-ANCA aids to set an early diagnosis 1–3. The finding of a positive C-ANCA on its own is by no means diagnostic of Wegener’s disease and the gold standard for diagnosis remains tissue biopsy 4.…”

“…Several case reports have been written about atypical presentations and related difficulties of diagnosing the disease at an early stage 1–3. Due to the high variety of presenting symptoms, these cases remain highly educational.…”

Meningoensefalitis Pada Wegener’s Granulomatosis dengan Anca Negatif: Laporan Kasus

“…Manifestasi paru terjadi pada sekitar 80-90% kasus, [18][19][20] dan Wegener's granulomatosis dengan manifestasi paru banyak yang pada awalnya diduga sebagai TB ataupun keganasan karena gambarannya yang mirip. [18][19][20][21] Penunjang lain yang mendukung diagnosis ini adalah hasil sitologi cairan pleura yang menyatakan adanya gambaran granulomatosis. Meskipun manifestasi kelainan paru paling banyak terjadi, tetapi manifestasi efusi pleura termasuk yang paling jarang terjadi (≤10%).…”