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以脉络膜肿瘤形式表现的肉芽肿性多血管炎。

Granulomatosis with polyangiitis presenting as a choroidal tumor.

作者信息

Masuda Taro, Izumi Yasumori, Takeshita Hayato, Kawahara Chieko, Tsuji Yoshika, Kurohama Hirokazu, Iwanaga Nozomi, Inamoto Miwako, Kase Keiichi, Ito Masahiro, Kawakami Atsushi, Migita Kiyosi

机构信息

Departments of General Internal Medicine and Rheumatology, Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki 856-8562, Japan.

Department of Pathology, Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki 856-8562, Japan.

出版信息

Case Rep Rheumatol. 2015;2015:271823. doi: 10.1155/2015/271823. Epub 2015 Apr 8.

DOI:10.1155/2015/271823
PMID:25949841
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4407635/
Abstract

Granulomatosis with polyangiitis (GPA) sometimes involves the eye orbit; however, choroidal involvements in GPA had been rarely reported. We report a rare case presenting with a choroidal mass in an 83-year-old Japanese woman who presented with left eye pain. Diagnostic biopsy revealed necrotizing vasculitis with infiltrates of inflammatory cells. Diagnosis was localized granulomatosis with polyangiitis. Combined treatments with corticosteroid plus azathioprine resolved the choroidal mass region. Although treatment with corticosteroid and immunosuppressive agents improves the prognosis of the disease, ocular morbidity is still well recognized. Clinicians should consider a differential diagnosis of GPA in patients with inflammatory choroidal tumors.

摘要

肉芽肿性多血管炎（GPA）有时会累及眼眶；然而，GPA累及脉络膜的情况鲜有报道。我们报告了一例罕见病例，一名83岁的日本女性因左眼疼痛就诊，检查发现脉络膜肿物。诊断性活检显示坏死性血管炎伴炎性细胞浸润。诊断为局限性肉芽肿性多血管炎。糖皮质激素联合硫唑嘌呤治疗使脉络膜肿物区域消退。尽管糖皮质激素和免疫抑制剂治疗可改善该病的预后，但眼部并发症仍很常见。临床医生应对炎性脉络膜肿瘤患者考虑GPA的鉴别诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e530/4407635/5b8ea8591a1b/CRIRH2015-271823.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e530/4407635/cf0332a612df/CRIRH2015-271823.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e530/4407635/9262cedd28b2/CRIRH2015-271823.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e530/4407635/c408ea042ccc/CRIRH2015-271823.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e530/4407635/ccf792bb049d/CRIRH2015-271823.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e530/4407635/fbf766d28dc6/CRIRH2015-271823.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e530/4407635/5b8ea8591a1b/CRIRH2015-271823.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e530/4407635/cf0332a612df/CRIRH2015-271823.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e530/4407635/9262cedd28b2/CRIRH2015-271823.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e530/4407635/c408ea042ccc/CRIRH2015-271823.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e530/4407635/ccf792bb049d/CRIRH2015-271823.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e530/4407635/fbf766d28dc6/CRIRH2015-271823.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e530/4407635/5b8ea8591a1b/CRIRH2015-271823.006.jpg

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本文引用的文献

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Granulomatosis with polyangiitis (Wegener): clinical aspects and treatment.肉芽肿性多血管炎（韦格纳）：临床特征和治疗。
Autoimmun Rev. 2014 Nov;13(11):1121-5. doi: 10.1016/j.autrev.2014.08.017. Epub 2014 Aug 20.
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Orbital granulomatosis with polyangiitis (Wegener granulomatosis): clinical and pathologic findings.眼眶肉芽肿性血管炎（韦格纳肉芽肿病）：临床与病理表现。
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