CT manifestations of pulmonary Wegener's granuloma -

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CT manifestations of pulmonary Wegener's granulomatosis

Of 345mol / L. Routine urine test: 6 cases of urinary protein +~+++。 urine occult blood +~++++, Blood: All patients had varying degrees of elevated white blood cell [(1】 .2 ~ 18. 6) x10L】. 1.2.2 Imaging in Table 1. 1.2.3 biopsy open lung biopsy in 1 case, 2 cases of thoracoscopic lung biopsy, percutaneous needle biopsy in 7 cases, 4 cases of nasal biopsy, the skin biopsy in 2 cases, pathology showed necrotizing granulomatous inflammation and vasculitis. 1'3 treatment and prognosis of immunosuppressive therapy in all patients after long-term remission after the majority of patients followed up for 2 to 48 months, only 2 patients were in the first 4,6 months of relapse, remission again after the same treatment. 2 discussion wG is a necrotizing granulomatous vasculitis, autoimmune diseases are more men than women, 40 to 50 years as high age. The lesions mainly involving the small arteries, veins and capillaries, and occasionally involving the aorta, the pathology is characterized by inflammation of the vessel wall, the main violations of the upper and lower respiratory tract and kidneys. wG usually nasal and lung tissue with focal granulomatous inflammation began and then progressed to a diffuse vascular necrotizing granulomatous inflammation. The most common pulmonary manifestations of cough, sputum, hemoptysis, dyspnea, and pleurisy, part of the secondary pulmonary infection, is often clinically misdiagnosed as tuberculosis, cancer and pneumonia. Vanderw0ude the first time in 1985 patients found wG ANCA, and report on its condition wC. ANCA is a kind of neutrophils and monocytes cytoplasmic components as the target antigen of autoantibodies, is divided into two subtypes: C-ANCA, the antigen is mainly PR3; P-ANCA, the antigen is mainly MP0. In which c-ANcA of wc with high sensitivity and specificity. Dongfeng beam turn reported active wG more than 9O% of patients were positive for c-ANcA ease some 40% of C-ANCA positive patients, specificity 90% to 97%. L3 cases in this group of patients (81.25%) c-ANcA positive. Therefore, c-ANcA Bay 0 for wc i seized the early diagnosis has important clinical significance. wG lung CT also has certain performance characteristics, the cT as following: (1) the existence of nodules of different sizes, mass and void lesions, manifested in multiple bilateral lung nodules of varying sizes, or round-like mass in the edge See thick burr, vague, peripheral lesions are distributed in both lungs and subpleural, and lungs, the lower part of common, and some of the visible lesions, Enhanced CT scan showed a nodule or mass visible edge 383 edge enhancement, central necrosis showed no enhancement,[link widoczny dla zalogowanych], and shadow can be seen to strengthen blood vessels into the nodule or mass, that is Empty, including thick, thin, and circular holes, of which the most characteristic ring hollow, empty the central low-density nodules can be seen, showing the I like the hollow wall of the WHO constitution, so the enhanced significantly enhanced. (2) consolidation and ground glass changes. Is mainly caused by alveolar hemorrhage, lung biopsy may be associated with inflammation and capillary microcirculation of necrosis. (3) wedge-shaped subpleural lesions, single or with multiple nodules, showing signs of vascular access and pleural thickening. (4) gas wall thickening, stenosis, may be complicated by atelectasis. Miss Sun and other f5] reported that about 4O% of the patients had wG include bronchial wall thickening and bronchial airways diseases such as bronchiectasis. (5) pleural effusion. In addition, interstitial infiltrates, hilar and mediastinal lymph nodes, calcified lesions, ridicule and other manifestations of spontaneous pneumothorax is also seen 3

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