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pulmonary Wegener granulomatosis

Thursday 12 August 2004

Synopsis

- pulmonary vasculitis

  • pulmonary arteritis
  • pulmonary venulitis
  • pulmonary capillaritis
  • pulmonary acute vasculitis (acute mural inflammation)
  • pulmonary chronic vasculitis (chronic mural inflammation)
  • pulmonary granulomatous vasculitis (granulomatous mural inflammation)
  • pulmonary vascular fibrinoid necrosis
  • pulmonary endotheliolitis (pulmonary endothelitis)

- pulmonary parenchymal lesions

  • pulmonary parenchymal necrosis
  • geographic necrosis
  • geographic necrotizing granuloma with palisading of histiocytes
  • neutrophilic microabscesses surrounded by granulomatous inflammation
  • necrotizing granuloma
  • granulomatous inflammation
  • palissading granuloma (palissading histiocytes)
  • scattered giant cells
  • interstitial fibrosis
  • scattered giant cells
  • poorly formed granulomas
  • sarcoid-like granulomas (rare)
  • vasculitis
    • granulomatous vasculitis
    • vascular fibrinoid necrosis
    • arteritis with fibrinoid necrosis
    • arteriolitis
    • capillaritis
    • venulitis
  • nodular interstitial fibrosis
  • endogenous lipoid pneumonia
  • alveolar hemorrhage
  • organizing intraluminal fibrosis
  • lymphocytic infiltrates
  • eosinophilic infiltrates
  • xanthogranulomatous lesions
  • alveolar macrophage accumulation

- bronchial lesions / bronchiolar lesions

  • chronic bronchiolitis
  • acute bronchiolitis
  • acute bronchopneumonia
  • bronchiolitis obliterans
  • BOOP histologic pattern
  • broncocentric granulomatosis
  • follicular bronchiolitis
  • bronchial stenosis

- granulomatous tuberculoid inflammation
- palisading microgranuloma
- interstitial fibrosis
- cicatricial vascular fibrosis
- focal bronchiolitis obliterans
- bronchocentric granulomatous inflammation

Differential diagnosis

- lymphomatoid granulomatosis (diffuse large B-cell lymphoma, DLBCL)
- Churg-Strauss disease
- sarcoidosis
- necrotizing sarcoid granulomatosis
- rheumatoid nodules
- bronchocentric granulomatosis
- granulomatous infections

  • mycobacterial infections

- diffuse pulmonary hemorrhage syndromes

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