Granulomatosis With Polyangiitis (GPA) Mimicking Metastatic Malignancy
Granulomatosis with polyangiitis is a rare vasculitis characterized by necrotizing granulomatous inflammation affecting small blood vessels. It often presents with pulmonary masses and nodules, mimicking malignancy in imaging studies. Distinguishing granulomatosis with polyangiitis from cancer is cr...
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| Veröffentlicht in: | Curēus (Palo Alto, CA) CA), 2024-10, Vol.16 (10), p.e71009 |
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| creator | Mohan, Abraham Kuriakose, Supriya M James, Lijo G, Bindu T Jangra, Suman Jose, Alisha T M, Deepu |
| description | Granulomatosis with polyangiitis is a rare vasculitis characterized by necrotizing granulomatous inflammation affecting small blood vessels. It often presents with pulmonary masses and nodules, mimicking malignancy in imaging studies. Distinguishing granulomatosis with polyangiitis from cancer is crucial due to differing treatment approaches and prognoses. We describe a 54-year-old male with granulomatosis with polyangiitis presenting with headache, bilateral ear discharge, cough, and weight loss. Imaging revealed metabolically active lesions in the lungs and nasopharynx, initially suggestive of metastatic malignancy. Biopsies from the lung and nasopharyngeal lesions showed necrotizing granulomatous vasculitis, which was suggestive of granulomatosis with polyangiitis. Serological testing was positive for cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA) with elevated proteinase 3 (PR3) antibodies. This case underscores the diagnostic challenges of granulomatosis with polyangiitis, which can mimic malignancy radiologically. Early recognition and treatment initiation are pivotal in improving patient outcomes and preventing organ damage in granulomatosis with polyangiitis. |
| doi_str_mv | 10.7759/cureus.71009 |
| format | Article |
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It often presents with pulmonary masses and nodules, mimicking malignancy in imaging studies. Distinguishing granulomatosis with polyangiitis from cancer is crucial due to differing treatment approaches and prognoses. We describe a 54-year-old male with granulomatosis with polyangiitis presenting with headache, bilateral ear discharge, cough, and weight loss. Imaging revealed metabolically active lesions in the lungs and nasopharynx, initially suggestive of metastatic malignancy. Biopsies from the lung and nasopharyngeal lesions showed necrotizing granulomatous vasculitis, which was suggestive of granulomatosis with polyangiitis. Serological testing was positive for cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA) with elevated proteinase 3 (PR3) antibodies. This case underscores the diagnostic challenges of granulomatosis with polyangiitis, which can mimic malignancy radiologically. Early recognition and treatment initiation are pivotal in improving patient outcomes and preventing organ damage in granulomatosis with polyangiitis.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.71009</identifier><identifier>PMID: 39507156</identifier><language>eng</language><publisher>United States: Cureus Inc</publisher><subject>Abdomen ; Antibiotics ; Biopsy ; Granulomas ; Histopathology ; Inflammation ; Internal Medicine ; Kidneys ; Lungs ; Lymphatic system ; Medical imaging ; Necrosis ; Pulmonology ; Rheumatology ; Sinusitis ; Tuberculosis</subject><ispartof>Curēus (Palo Alto, CA), 2024-10, Vol.16 (10), p.e71009</ispartof><rights>Copyright © 2024, Mohan et al.</rights><rights>Copyright © 2024, Mohan et al. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2024, Mohan et al. 2024 Mohan et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2159-dbc821dde27d46c7c2add004447c1e8b7b846d572a99ca4aedf7f31527095ab3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11540042/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11540042/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39507156$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mohan, Abraham</creatorcontrib><creatorcontrib>Kuriakose, Supriya M</creatorcontrib><creatorcontrib>James, Lijo</creatorcontrib><creatorcontrib>G, Bindu T</creatorcontrib><creatorcontrib>Jangra, Suman</creatorcontrib><creatorcontrib>Jose, Alisha T</creatorcontrib><creatorcontrib>M, Deepu</creatorcontrib><title>Granulomatosis With Polyangiitis (GPA) Mimicking Metastatic Malignancy</title><title>Curēus (Palo Alto, CA)</title><addtitle>Cureus</addtitle><description>Granulomatosis with polyangiitis is a rare vasculitis characterized by necrotizing granulomatous inflammation affecting small blood vessels. 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Early recognition and treatment initiation are pivotal in improving patient outcomes and preventing organ damage in granulomatosis with polyangiitis.</description><subject>Abdomen</subject><subject>Antibiotics</subject><subject>Biopsy</subject><subject>Granulomas</subject><subject>Histopathology</subject><subject>Inflammation</subject><subject>Internal Medicine</subject><subject>Kidneys</subject><subject>Lungs</subject><subject>Lymphatic system</subject><subject>Medical imaging</subject><subject>Necrosis</subject><subject>Pulmonology</subject><subject>Rheumatology</subject><subject>Sinusitis</subject><subject>Tuberculosis</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkUFLAzEQhYMoVtSbZ1nwUsFqkk02uycR0Sq06KHgMcwmaZu6m9RkV-i_d21rUU8zzHy8mcdD6IzgayF4caPaYNp4LQjGxR46oiTLBznJ2f6vvodOY1xgjAkWFAt8iHppwbEgPDtCj8MArq18DY2PNiZvtpknr75agZtZ23ST_vD17jIZ29qqd-tmydg0EBtorErGUNmZA6dWJ-hgClU0p9t6jCaPD5P7p8HoZfh8fzcaKEp4MdClyinR2lChWaaEoqA1xowxoYjJS1HmLNNcUCgKBQyMnoppSjgVuOBQpsfodiO7bMvaaGVcE6CSy2BrCCvpwcq_G2fncuY_JSGcdXdop9DfKgT_0ZrYyNpGZaoKnPFtlCmhnBUZW6MX_9CFb4Pr7HVU2hECc9xRVxtKBR9jMNPdNwTL74zkJiO5zqjDz3872ME_iaRfQ-iOGg</recordid><startdate>20241007</startdate><enddate>20241007</enddate><creator>Mohan, Abraham</creator><creator>Kuriakose, Supriya M</creator><creator>James, Lijo</creator><creator>G, Bindu T</creator><creator>Jangra, Suman</creator><creator>Jose, Alisha T</creator><creator>M, Deepu</creator><general>Cureus Inc</general><general>Cureus</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20241007</creationdate><title>Granulomatosis With Polyangiitis (GPA) Mimicking Metastatic Malignancy</title><author>Mohan, Abraham ; 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It often presents with pulmonary masses and nodules, mimicking malignancy in imaging studies. Distinguishing granulomatosis with polyangiitis from cancer is crucial due to differing treatment approaches and prognoses. We describe a 54-year-old male with granulomatosis with polyangiitis presenting with headache, bilateral ear discharge, cough, and weight loss. Imaging revealed metabolically active lesions in the lungs and nasopharynx, initially suggestive of metastatic malignancy. Biopsies from the lung and nasopharyngeal lesions showed necrotizing granulomatous vasculitis, which was suggestive of granulomatosis with polyangiitis. Serological testing was positive for cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA) with elevated proteinase 3 (PR3) antibodies. This case underscores the diagnostic challenges of granulomatosis with polyangiitis, which can mimic malignancy radiologically. Early recognition and treatment initiation are pivotal in improving patient outcomes and preventing organ damage in granulomatosis with polyangiitis.</abstract><cop>United States</cop><pub>Cureus Inc</pub><pmid>39507156</pmid><doi>10.7759/cureus.71009</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Abdomen Antibiotics Biopsy Granulomas Histopathology Inflammation Internal Medicine Kidneys Lungs Lymphatic system Medical imaging Necrosis Pulmonology Rheumatology Sinusitis Tuberculosis |
| title | Granulomatosis With Polyangiitis (GPA) Mimicking Metastatic Malignancy |
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