Unusual radiographic features of Wegener's granulomatosis.

The classical radiologic manifestations of Wegener's granulomatosis are paranasal sinus disease and pulmonary nodules. A review of 31 clinicopathologically proven cases of Wegener's granulomatosis was undertaken to delineate some of the atypical radiologic presentations in this disorder. In 16 of the 31 patients a total of 18 atypical radiographic findings were demonstrated. These included lesions of the airways, parenchyma, pleura, and kidneys. We feel the "typical radiologic findings" of Wegener's granulomatosis should be expanded to include (1) endobronchial disease resulting in atelectasis of either a lobe or a complete lung, and (2) pleural disease with thickening or effusion which may be massive. While some of the rarer presentations are still not included, such a redefinition would cover more than 75% of our 31 cases.