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Pulmonary angiitis and granulomatosis: radiologic-pathologic correlation

A A Frazier1, M L Rosado-de-Christenson, J R Galvin

  • 1Department of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|May 26, 1998
PubMed
Summary

Pulmonary angiitis and granulomatosis encompasses five syndromes, often presenting with respiratory symptoms and sometimes affecting kidneys or airways. Treatment involves cytotoxic agents and corticosteroids, with variable prognosis.

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Area of Science:

  • Pulmonary Medicine
  • Rheumatology
  • Pathology

Background:

  • Pulmonary angiitis and granulomatosis comprises five distinct clinical syndromes.
  • These conditions often manifest in middle-aged adults with symptoms like fever, cough, and dyspnea.

Purpose of the Study:

  • To review the clinical, pathological, and radiological features of five distinct syndromes of pulmonary angiitis and granulomatosis.
  • To discuss the differential diagnosis and treatment of these rare pulmonary conditions.

Main Methods:

  • Review of clinical presentations, including symptoms and organ involvement (upper airway, renal, asthma).
  • Pathological findings characterized by vasculitis, granulomatous inflammation, and necrosis.
  • Radiological manifestations, focusing on nodular or diffuse opacities and cavitation.

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Main Results:

  • Syndromes include Wegener granulomatosis, lymphomatoid granulomatosis, necrotizing sarcoid granulomatosis, bronchocentric granulomatosis, and Churg-Strauss syndrome.
  • Radiologically, multiple nodules/masses with cavitation or diffuse air-space opacities are typical.
  • Pulmonary hemorrhage can be a presenting feature, particularly in Wegener granulomatosis and Churg-Strauss syndrome.

Conclusions:

  • Differential diagnosis must consider pulmonary metastases and infections due to multifocal lung involvement.
  • Treatment typically involves cytotoxic agents and corticosteroids.
  • Prognosis varies by syndrome but can be favorable if complications are absent.