Rhinologic changes in Wegener’s granulomatosis

Lloyd, Glyn A. S.; Lund, Valerie J.; Beale, Tim; Howard, David

doi:10.1258/002221502760132737

Cited by 66 publications

(63 citation statements)

References 6 publications

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“…In the later stage of granulomatous transformation, granulomas can be depicted as low-signal-intensity lesions at T1W and T2W images in the nasal cavity, paranasal sinuses and orbits [139]. In a patient without a clinical history of previous sinonasal surgery, a combination of bone destruction and new bone formation on CT, especially when accompanied by a fat signal from the sclerotic sinus walls using MR, can be used as a diagnostic tool for WG when the clinical diagnosis may be uncertain and the cANCA test is negative [140,141]. Idiopathic or lethal midline granuloma used to be classified as a granulomatous disease, but is now classified as lymphoma [142,143].…”

Section: Wegener's Granulomatosismentioning

confidence: 99%

Radiological imaging of inflammatory lesions in the nasal cavity and paranasal sinuses

Eggesbø

2006

Eur Radiol

120

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Paranasal sinus development and pneumatisation variants are described, and rhinosinusitis and different patterns of inflammatory sinonasal diseases are reviewed. Other inflammatory sinonasal diseases, e.g., fungal sinusitis, mucocele, pyocele and sinonasal manifestations in systemic diseases, are briefly described. Computed tomography (CT) is the primary modality in diagnosing and mapping suspected inflammatory sinonasal disease. Magnetic resonance (MR) imaging is complementary to CT if fungal sinusitis, pyocele or malignancy are suspected.

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Section: Wegener's Granulomatosismentioning

confidence: 99%

Radiological imaging of inflammatory lesions in the nasal cavity and paranasal sinuses

Eggesbø

2006

Eur Radiol

120

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“…23,24 Magnetic resonance imaging can detect areas of abnormal nasal or paranasal mucosa. 11,25 In cocaine abusers, significant enlargement of the palatine or pharyngeal tonsils has been associated with small fluid collections within lymphatic tissue. 23 Radiographic signs of otitis media may also be detected.…”

Section: Discussionmentioning

confidence: 99%

Craniovertebral junction instability as an extension of cocaine-induced midline destructive lesions: case report

Brembilla¹,

Lanterna²,

Risso³

et al. 2015

SPI

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With the increasingly widespread illicit use of cocaine, a broad spectrum of clinical pathologies related to this form of drug abuse is emerging. The most frequently used method of administration of powdered cocaine is intranasal inhalation, or “snorting.” Consequently, adverse effects of cocaine on the nasal tract are common. Habitual nasal insufflations of cocaine can cause mucosal lesions. If cocaine use becomes chronic and compulsive, progressive damage of the mucosa and perichondrium leads to ischemic necrosis of the septal cartilage and perforation of the nasal septum. Occasionally, cocaine-induced lesions cause extensive destruction of the osteocartilaginous structures of the nose, sinuses, and palate and can mimic other diseases such as tumors, infections, and immunological diseases. In the literature currently available, involvement of the craniovertebral junction in the cocaine-induced midline destructive lesions (CIMDLs) has never been reported. The present case concerns a 44-year-old man who presented with long-standing symptoms including nasal obstruction, epistaxis, dysphagia, nasal reflux, and severe neck pain. A diagnosis of CIMDL was made in light of the patient’s history and the findings on physical and endoscopic examinations, imaging studies, and laboratory testing. Involvement of the craniovertebral junction in the destructive process was evident. For neurosurgical treatment, the authors considered the high grade of atlantoaxial instability, the poorly understood cocaine-induced lesions of the spine and their potential evolution overtime, as well as cocaine abusers’ poor compliance. The patient underwent posterior craniovertebral fixation. Understanding, classifying, and treating cocaine-induced lesions involving the craniovertebral junction are a challenge.

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“…Positron emission tomography can assess inflammatory activity of large arteries. specific for Wegener's granulomatosis in a patient without a history of previous sinonasal surgery [3]. CT and MRI detected rhinologic changes in 28 patients with Wegener's granulomatosis, 10 of whom had the clinical diagnosis of sinonasal vasculitis.…”

Section: Wegener's Granulomatosismentioning

confidence: 96%

“…CT and MRI detected rhinologic changes in 28 patients with Wegener's granulomatosis, 10 of whom had the clinical diagnosis of sinonasal vasculitis. Eighty-six percent of the patients had mucosal thickening in the nasal cavity or paranasal sinuses, 75% had evidence of bone destruction, and 50% had evidence of new bone formation [3].…”

Section: Wegener's Granulomatosismentioning

confidence: 99%

Use of imaging studies in the diagnosis of vasculitis

Schmidt¹

2004

Curr Rheumatol Rep

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Imaging studies are necessary to determine disease extension and disease activity in the small-vessel vasculitides. Computed tomography (CT) and magnetic resonance imaging (MRI) increase the number of pathologic findings compared with conventional radiography. MRI delineates mucosal inflammation and granulomas in the paranasal sinuses, whereas CT provides information about osseous lesions. CT is superior to MRI for the detection of pulmonary lesions. Radiograph angiography has been the gold standard for medium- and large-vessel vasculitides for decades. Echocardiography and MRI correspond well with conventional angiography to assess cardiac involvement in Kawasaki disease. MRI, CT, and CT angiography are alternative noninvasive techniques to delineate vasculitic lesions in polyarteritis nodosa, Takayasu's arteritis, and large-vessel giant cell arteritis. Duplex ultrasonography has the greatest resolution. It delineates typical artery wall swelling in temporal arteritis and Takayasu's arteritis. Positron emission tomography can assess inflammatory activity of large arteries.

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Rhinologic changes in Wegener’s granulomatosis

Cited by 66 publications

References 6 publications

Radiological imaging of inflammatory lesions in the nasal cavity and paranasal sinuses

Radiological imaging of inflammatory lesions in the nasal cavity and paranasal sinuses

Craniovertebral junction instability as an extension of cocaine-induced midline destructive lesions: case report

Use of imaging studies in the diagnosis of vasculitis

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