CTICasesGranulomatosis with Polyangiitis (GPA) with Airway Stenosis
▶ Watch on YouTube — age-restricted, cannot embed here
Imaging findings
The patient has a history of a left pulmonary artery stent and chronic destruction of the left lung. An early-phase CT shows a 'smoke phenomenon' (early filling of the left heart) due to altered flow, but no pulmonary embolism. The trachea and main bronchi demonstrate circumferential soft tissue thickening, characteristic of GPA, with involvement of the posterior membrane. A new, short-segment, tight stenosis with a 'web' or 'shelf' is noted just below the thoracic inlet, which had worsened compared to prior studies.
Key takeaways
In patients with granulomatosis with polyangiitis and known airway involvement, meticulous evaluation of the airways, especially with multiplanar reformats, is crucial to detect worsening stenosis. Such narrowing, even if short-segment, can be the cause of acute dyspnea and stridor. The 'smoke phenomenon' in the pulmonary circulation can result from underlying chronic lung disease altering vascular resistance and shunting.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Infected Breast Reduction Seroma / AbscessIatrogenic
- Breast Cancer Recurrence (Internal Mammary Lymph Node Metastasis)Neoplastic
- Cement Embolization to Pulmonary Arteries after VertebroplastyIatrogenic
- Tuberculous Tracheobronchitis and Pulmonary TuberculosisInfection
- Non-Functioning Mediastinal Paraganglioma with Pulmonary EmbolismNeoplastic
- Incidental Mediastinal ParagangliomaNeoplastic
- Mediastinal Fat InfarctionArtifact
- Massive Tricuspid Valve Vegetations with EmbolizationInfection
See all cases from May 28, 2016 →