2016 Volume 28 Issue 2 Pages 158-163
A 72-year old man was referred to our hospital because of shortness of breath for 1.5 years and 7 kg weight loss for 2 months. High-resolution computed tomography (HRCT) revealed interstitial pneumonia and myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) was serologically positive (47.2 U / mL). At the same time, stage I sigmoid colon cancer was revealed by colonoscopy. Therefore, sigmoid colectomy was performed. Vasculitis were histologically detected in submucosa and subserosa of the resected specimen together with well-differentiated adenocarcinoma. Microscopic polyangiitis (MPA) was diagnosed and treated with prednisolone (30 mg / day) and azathioprine (50 mg / day). After immunosuppression therapy, MPO-ANCA became negative and interstitial pneumonia improved gradually on HRCT. In this report, we discuss the relationship between malignancy and vasculitis. In addition, we added a retrospective review of 82 patients diagnosed with ANCA-associated vasculitis (AAV), who had attended our hospital from 2010 to 2015. Among them, 17 patients suffered from malignancy, and all were solid tumor. In 6 cases, AAV and malignancy were detected concurrently, and their malignancy was all in early stage. Three of the 6 patients had gastric cancer, 1 with colon cancer, and 2 with breast cancer. It is suggested that we should be careful about complication with AAV and malignancy.
