Respiratory Medicine Case Reports (Jan 2023)

Anti-neutrophil cytoplasmic antibody-negative granulomatosis with polyangiitis manifesting through pulmonary nodules and a genital lesion

  • Yuriko Mikami-Saitoh,
  • Hiroyuki Kyoyama,
  • Yusuke Hirata,
  • Satoshi Kikuchi,
  • Kosuke Sakai,
  • Shintaro Mikami,
  • Gaku Moriyama,
  • Nobuyuki Koyama,
  • Morihiro Higashi,
  • Akihiro Ishizu,
  • Kazutsugu Uematsu

Journal volume & issue
Vol. 46
p. 101951

Abstract

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A 72-year-old female presented with bilateral pulmonary nodules before undergoing surgery for hysteroptosis. Transbronchial biopsy did not lead to a definitive diagnosis. The right mass in the upper lobe was resected through video-assisted thoracic surgery. Pathological findings showed granulomatosis with polyangiitis. However, the patient was negative for serum proteinase 3-anti-neutrophil cytoplasmic antibody. Although the nodule in the left lower lobe progressed, the serum inflammatory reaction yielded negative results. Resection of the nodule in the left lower lobe revealed identical pathological findings with those of the right pulmonary mass. Following total hysterectomy for hysteroptosis, the pathological findings indicated granulomatosis with polyangiitis.

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