Department of Medicine, Division of Respirology, Neurology and Rheumatology, Kurume University School of Medicine, Japan.
Department of Pathology, Kurume University School of Medicine, Japan.
Intern Med. 2021;60(23):3823-3826. doi: 10.2169/internalmedicine.6541-20. Epub 2021 Dec 1.
We herein report an unusual case of granulomatosis with polyangiitis (GPA) in a 65-year-old man in whom relapsed disease manifested as an anterior cheek nodule. Magnetic resonance imaging indicated the differential diagnoses of the subcutaneous nodule in the patient's anterior cheek to be inflammatory granulomatous lesions with GPA, malignancy, or infectious disease. A histopathological examination ruled out malignancy and infectious diseases, and necrotizing vasculitis was suspected. The subcutaneous nodule was successfully treated using rituximab, suggesting that it was associated with GPA, secondary to vasculitis. Clinicians should be aware of the possibility of such a rare manifestation of GPA.
我们在此报告一例 65 岁男性的肉芽肿性多血管炎(GPA)复发病例,其复发表现为面颊前部结节。磁共振成像提示患者面颊前部皮下结节的鉴别诊断包括 GPA 相关炎症性肉芽肿性病变、恶性肿瘤或感染性疾病。组织病理学检查排除了恶性肿瘤和感染性疾病,疑诊坏死性血管炎。使用利妥昔单抗成功治疗了皮下结节,提示其与 GPA 相关,继发于血管炎。临床医生应意识到 GPA 这种罕见表现的可能性。