CTICasesGranulomatosis with Polyangiitis
Imaging findings
Chest CT in a young patient presenting with hemoptysis shows a large, thick-walled cavity in the left lower lobe and patchy ground-glass consolidation (alveolar hemorrhage) in the right upper lobe. Urinalysis is abnormal. Kidney biopsy reveals a necrotizing crescentic glomerulonephritis, and PR3-ANCA is positive.
Key takeaways
Granulomatosis with polyangiitis (GPA/Wegener's) is a systemic autoimmune vasculitis affecting small-to-medium vessels, classically involving the upper respiratory tract (sinuses), lungs, and kidneys. Pulmonary manifestations include multiple nodules or cavities, often with surrounding ground-glass halos representing hemorrhage. Positive PR3-ANCA and renal biopsy are diagnostic.
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