Presentation
No previous medical history. Admitted with hemoptysis.
Patient Data
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Confluent air space opacities in the medial parts of both upper zones, more pronounced on the left. Obliteration of the aortic arch silhouette. No pneumothorax, effusion or cavitation.
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A single CT image during biopsy of the right upper lobe demonstrates confluent consolidation, more marked on the left with air-bronchograms.
Case Discussion
Initially, a core biopsy of the right lung lesion was performed but it was non-diagnostic.
A subsequent surgical biopsy of the left lung lesion showed granulomatosis with polyangiitis (previously known as Wegener granulomatosis).
Unfortunately, the patient had a very rapid downhill course with renal failure and expired at the time that treatment for Wegener was going to be started. Stains for microorganisms and cultures were all negative.