Abstract
Background. Bronchial involvement of Wegener's granulomatosis (WG) is very rare. We report a case of WG presenting with various types of bronchial involvement, referring to previous reports and adding to our consideration. Case. A 55-year-old woman was referred to our hospital because of otorrhea and hearing loss. At first a diagnosis of exudative tympanitis was made, and right side tympanoplasty was performed. After 2 months, she was admitted to our hospital for left side tympanoplasty. At hospitalization, a chest X-ray abnormality was poined out. Chest CT scan showed a mass with cavitation in the right lower lung field and stenosis of the left main bronchus. Moreover, WG was suspected because of PR3-ANCA elevation. She only had mild cough. However, on flexible bronchoscopy, the trachea and bilateral main bronchus showed various findings of protrusions, stenosis, ulcerative bronchitis and so on. Transbronchial biopsy was done, and the histologic findings of the right B^9_b showed infiltration of lymphocytes and surrounding multicentric giant cells with granulomatous features. WG was diagnosed. Treatment with high dose prednisolone and cyclophosphamide markedly improved her symptoms and bronchoscopic findings. Conclusion. This case report emphasizes various types of tracheobronchial involvement in WG despite only mild respiratory symptoms.
