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Wegner's granulomatosis


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Wegner's granulomatosis

  1. 1. Wegner’sGranulomatosisDr/ Hytham NafadyHertz
  2. 2. DefinitionMultisystem disease of unknown etiologycharacterized by• Granulomatous necrotizing small vesselvasculitis of the upper & lower respiratorytract &• Glomerulonephritis.
  3. 3. Wegner’s granulomatosis involves the• upper respiratory tract in 100% of cases,• lower respiratory tract in 90% of cases &• kidneys in 80% of cases, &• Tracheo-bronchial tree in 60% of cases.
  4. 4. Demographics• Age: around 45.• M>F
  5. 5. C.P• Rhinitis, sinusitis & epistaxis.• Cough & hemoptysis.• Hematuria & Chronic renal failure,which is the cause of death.• Lab: elevated (c-ANAC) antineutrophilantibodies.• Renal biopsy: glomerulonephritis,which is diagnostic.
  6. 6. Radiological manifestations
  7. 7. Respiratory manifestationsofWegner’s granulomatosisNodulesAlveolaropacitiesAirwaysGroundglassopacitiesConsolidationSubglottictrachealstenosisBronchialstenosisCavitatingNon cavitating
  8. 8. Rare manifestations of WG• Interstitial abnormalities (thickening ofinterlobular sepat).• Hilar lymphadenopathy.• Pleural thickening or effusion.
  9. 9. Nodules• Single or multiple.• Small or large (few mm to 10 cm).• Cavitating or non cavitating.• Thin walled (1-3 mm) or thick walled (> 3mm) cavities.• Halo sign (due to surrounding alveolarhemorrhage).• Reversed halo sign.
  10. 10. Halo sign
  11. 11. Reversed halo sign
  12. 12. Alveolar WGDue to alveolar hemorrhage.Alveolar WGGround glass opacities ConsolidationCentrilobular nodules Patchy distribution
  13. 13. Centrilobular nodules of GG density
  14. 14. GGO with patchy distribution
  15. 15. Consolidation
  16. 16. Airway WG• Subglottic tracheal stenosis.• Bronchial stenosis
  17. 17. Case27-year-old woman involved in a severe motorvehicle collision years ago with a prolongedhospital course now presents with a severalmonths history of progressive dyspnea.• What is the pertinent radiologic finding?• What is your differential diagnosis?• What is your favorite diagnosis?
  18. 18. DD of tracheal stenosis