Presentation
No previous medical history. Admitted with hemoptysis.
Patient Data
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.
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.