Urbanska Edyta Maria, Elversang Johanna, Colville-Ebeling Bonnie, Löfgren Johan Olof, Nelveg-Kristensen Karl Emil, Szpirt Wladimir M
Department of Oncology, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark.
Department of Pathology, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark.
Clin Pract. 2021 May 14;11(2):293-302. doi: 10.3390/clinpract11020042.
Diagnosis of anomalous intrathoracic lesions may be challenging and require a multidisciplinary approach. We present a case of granulomatosis with polyangiitis (GPA) clinically and radiologically mimicking metastatic lung cancer with a bilateral pulmonary mass, mediastinal and cervical lymph node involvement, and pleural effusion. Surgical biopsy of the thoracic lesion revealed necrotic granulomatous inflammation, and the final diagnosis was subsequently confirmed by kidney biopsy and biochemical parameters. This case illustrates how comprehensive diagnosis secures timely and relevant treatment. Systemic vasculitis may be one of the key differential diagnoses in patients with multiorgan involvement, especially with pattern-mimicking lung cancer.
诊断胸内异常病变可能具有挑战性,需要多学科方法。我们报告一例肉芽肿性多血管炎(GPA)病例,该病例在临床和放射学上模仿转移性肺癌,表现为双侧肺部肿块、纵隔和颈部淋巴结受累以及胸腔积液。对胸部病变进行手术活检显示坏死性肉芽肿性炎症,最终诊断随后通过肾脏活检和生化参数得以证实。该病例说明了全面诊断如何确保及时且恰当的治疗。系统性血管炎可能是多器官受累患者尤其是具有类似肺癌表现患者的关键鉴别诊断之一。