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Lessons of the month: ANCA-associated vasculitis - granulomatosis with polyangiitis: 'the great mimic'
- Source :
- Clin Med (Lond)
- Publication Year :
- 2021
-
Abstract
- We describe the case of a 61-year-old woman who presented with progressive respiratory symptoms and imaging demonstrating multiple opacities in the right lung with hilar and mediastinal lymphadenopathy suggestive of multifocal adenocarcinoma. Subsequent biopsies were consistent with focal changes of organising pneumonia (OP) and no evidence of malignancy. She was treated with steroids for cryptogenic OP with limited response. There was clinical and radiological progression with new lung nodules, mediastinal and thoracic spinal canal infiltration. There was ongoing concern that clinical findings represented disseminated malignancy. Following further investigation and multidisciplinary respiratory and rheumatology review, a diagnosis of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) - granulomatosis with polyangiitis (GPA) was confirmed. The case highlighted the multisystem nature of GPA with unusual dural and large vessel aortic and pulmonary trunk involvement.
- Subjects :
- medicine.medical_specialty
Pathology
Mediastinal lymphadenopathy
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
030204 cardiovascular system & hematology
Malignancy
Antibodies, Antineutrophil Cytoplasmic
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
030212 general & internal medicine
Lung
Aortitis
business.industry
Lessons of the Month
Granulomatosis with Polyangiitis
General Medicine
Middle Aged
medicine.disease
Rheumatology
medicine.anatomical_structure
Adenocarcinoma
Female
Vasculitis
Granulomatosis with polyangiitis
business
Subjects
Details
- ISSN :
- 14734893
- Volume :
- 21
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Clinical medicine (London, England)
- Accession number :
- edsair.doi.dedup.....2ff2a53e13d11507caa2668604eed594