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Updated: May 8, 2026

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
[Henoch-Schönlein Purpura with lung abscess]
Junji Nakazawa1, Atsushi Watanabe, Tomohiro Nakajima
1Department of Cardiovascular and General Thoracic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
A lung abscess initially mimicking cancer in a 72-year-old man was diagnosed and successfully treated. This case highlights the importance of considering non-malignant conditions in post-cancer imaging findings.
Area of Science:
- Pulmonology
- Nephrology
- Rheumatology
Background:
- A 72-year-old male underwent left lower lobectomy for stage IA squamous cell carcinoma.
- Follow-up imaging revealed new cavitary nodules in the right lung, suspicious for metastasis.
Observation:
- Fluorodeoxyglucose-positron emission tomography (FDG-PET) showed positive uptake in the nodules.
- Transbronchial biopsy and partial resection of a nodule confirmed lung abscess, not malignancy.
- The patient later presented with purpuric rash, fever, arthralgia, and microscopic albuminuria.
Findings:
- Renal biopsy revealed nephritis with immunoglobulin A (IgA) deposition, leading to a diagnosis of Henoch-Schönlein purpura.
- Oral steroid therapy (prednisolone) resolved the patient's symptoms and lung nodules.
Implications:
- This case underscores the diagnostic challenge of differentiating lung abscess from metastatic cancer on imaging.
- It highlights the rare association between lung abscess and Henoch-Schönlein purpura.
- Prompt diagnosis and steroid treatment were crucial for managing both conditions.
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