Spontaneous Disappearance of a Pulmonary Lesion in a Patient with Active Wegener's Granulomatosis

Abstract

Spontaneous regression of a pulmonary lesion in patients with Wegener's granulomatosis (WG) is rare, and only a few such reports have been published. We describe a rare case of a patient with WG in which the pulmonary lesion regressed spontaneously. The patient was a 76-year-old man presenting with fever, sputum and cough. On serial CTs, he had a solitary nodule in the right lung that regressed spontaneously while new multiple nodules developed during a 1-month interval. Biopsy of the new lesions by video-assisted thoracostomy (VATS) established a diagnosis of WG. Treatment with glucocorticoid and cyclophosphamide significantly ameliorated his condition. Concordant with similar previous reports, the mechanisms behind spontaneous regression of pulmonary lesions in the present case seemed to include spontaneous improvement of infection or infarction caused by vasculitis, in addition to regression of the WG lesion itself. Although it occurs rarely, physicians should be aware of the phenomenon that pulmonary lesions in WG could progress and regress spontaneously.