A case of Wegener's granulomatosis complicated with a lung abscess, treated by left upper lobectomy

Abstract

The patient was a 73-year-old man who had been treated for renal dysfunction due to Wegener's granulomatosis in our hospital's Department of Internal Medicine. His chief complaint was a cough, and a thorough chest examination was conducted. An abnormal left upper lung shadow was noted on a chest radiograph, and occlusion of the left upper division bronchus, with atelectasis of the left superior lung segment, was observed on chest CT. Bronchoscopy showed bronchial occlusion and hemorrhage, in which squamous metaplasia was detected employing biopsy. An accumulation of fluorodeoxyglucose (FDG) was noted in the left upper lobe on PET. From these findings, left upper lung cancer was strongly suspected, for which we subsequently performed a left upper lobectomy. However, the post-operative pathology disclosed that an abscess had formed due to bronchodilatation with airway infection caused by Wegener's granulomatosis.