Giant cell arteritis with pulmonary nodules

A patient presenting with polymyalgia rheumatica and biopsy-proved temporal arteritis showed response to corticosteroid therapy. Nodular pulmonary lesions developed twice, and diplopia and unilateral visual loss once, after reduction of the steroid dose. Response to reinstitution of full-dose steroids was dramatic. The clinical and pathologic findings in this patient suggest that the pulmonary lesions represented a previously undescribed manifestation of giant cell arteritis, but the possibility of limited Wegener's granulomatosis involving the temporal artery could not be ruled out.