Wegener's granulomatosis diagnosed by open lung biopsy

A 21 year old man was diagnosed as having Wegener's granulomatosis at thoracotomy. Treatment with prednisolone and cyclophosphamide was initiated but the patient died 4 months later. Wegener's granulomatosis is a rare disease which should be considered in the differential diagnosis of pulmonary malignancies, tuberculosis and lung abscess. Early diagnosis is mandatory for a favourable outcome. Open lung biopsy is recommended, if other examinations have failed, as large representative biopsies can be obtained.