A Case of Pulmonary Granulomatosis with Polyangiitis Mimicking Septic Pneumonia Resulting from Middle Ear Infection

초록

Granulomatosis with polyangiitis (GPA) is a multisystemic disease characterized by necrotizing granulomatous vasculitis, which histopathologically presents as vasculitis and granulomas with multinucleated giant cells. In pulmonary GPA, pulmonary cavity is a commonly observed imaging pattern although nodule and consolidation are the most common imaging findings. This cavitation follows a fluid-filled space within a pulmonary consolidation, a mass, or a nodule through the expulsion or drainage of a low-attenuation necrotic part of the lesion via the bronchial tree. However, in previous CT studies of pulmonary GPA, most cavitations appear as gas-filled spaces rather than accompanying necrotic fluid-attenuation areas. Therefore, we report a case of pulmonary GPA that presented with consolidations and nodules accompanied by a central low-attenuation area on CT, which mimicked septic pneumonia.

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