Abstract
Two cases of Wegener's granulomatosis diagnosed by surgical lung biopsy are reported. A 59-year-old man was admitted to our hospital because of slight fever and cough in July 2003. Chest radiograph showed a mass shadow adjacent to the right pulmonary hilum. Although cytoplasmic-antineutrophil cytoplasmic antibody (C-ANCA) test was positive, the tumor was surgically biopsied because malignancy could not be ruled out from the radiological findings. Surgical biopsy specimens showed the geographical necrosis with granulomatous inflammation and angiitis compatible with typical findings of Wegener's granulomatosis. Oral administration of prednisolone combined with cyclophosphamide was successfully performed. Another case was a 53-year-old woman complaining of nasal obstruction and nasal discharge. Paranasal sinus CT showed a space-occupying lesion, and chest CT showed a mass in right lower lobe, suggesting Wegener's granulomatosis. However, C-ANCA test was negative. Histological specimens obtained from right lower lobe showed typical findings of Wegener's granulomatosis. Oral prednisolone and cyclophosphamide treatment markedly improved clinical symptoms.
