Yilmaz Ayşe, Ocal Serpil, Sezer Engin, Inönü Handan, Yemenici Hasibe, Seyfikli Zehra
Department of Chest Diseases, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey.
Tuberk Toraks. 2009;57(3):352-5.
Wegener's granulomatosis is a type of vasculitis characterized by necrotizing granulomatosis respiratory tract lesions and necrotising glomerulonephritis. Nasal, lung and renal biopsies and positive antineutrophil cytoplasmic antibody (c-ANCA) analysis is helpful in diagnosis. Early diagnosis and treatment is critical in prognosis. A 42 years-old male had dyspnea, coughing, hemoptysis, fatigue, loss of appetite, night sweating and arthralgia. Violaceous palpable, purpuric lesions were detected on the sublingual region of the mouth. On chest X-ray, there was nonhomogeneous infiltration in the parenchyma of both lungs. There was alveolar density involving upper lobes of both lungs detected in thoracal computerized tomography as well as patchy densities on the right lung upper-middle lobes. A nasal mucosa biopsy showed strongly destructive vasculitis. c-ANCA test was positive. We report an unusual case with Wegener's granulomatosis, characterized by a rare presentation of tongue involvement and atypical lung radiology with alveolar opacity.
韦格纳肉芽肿病是一种血管炎，其特征为坏死性肉芽肿性呼吸道病变和坏死性肾小球肾炎。鼻、肺和肾活检以及抗中性粒细胞胞浆抗体（c-ANCA）分析呈阳性有助于诊断。早期诊断和治疗对预后至关重要。一名42岁男性出现呼吸困难、咳嗽、咯血、疲劳、食欲不振、盗汗和关节痛。在口腔舌下区域检测到可触及的紫蓝色紫癜性病变。胸部X线检查显示双肺实质有不均匀浸润。胸部计算机断层扫描显示双肺上叶有肺泡密度影，右肺上中叶有斑片状密度影。鼻黏膜活检显示严重破坏性血管炎。c-ANCA检测呈阳性。我们报告一例不寻常的韦格纳肉芽肿病病例，其特征为罕见的舌部受累表现和伴有肺泡混浊的非典型肺部影像学表现。
