Anti-neutrophil cytoplasmic antibody-negative granulomatosis with polyangiitis manifesting through pulmonary nodules and a genital lesion

Yuriko Mikami-Saitoh; Hiroyuki Kyoyama; Yusuke Hirata; Satoshi Kikuchi; Kosuke Sakai; Shintaro Mikami; Gaku Moriyama; Nobuyuki Koyama; Morihiro Higashi; Akihiro Ishizu; Kazutsugu Uematsu

doi:10.1016/j.rmcr.2023.101951

Anti-neutrophil cytoplasmic antibody-negative granulomatosis with polyangiitis manifesting through pulmonary nodules and a genital lesion

Respir Med Case Rep. 2023 Dec 3:46:101951. doi: 10.1016/j.rmcr.2023.101951. eCollection 2023.

Affiliations

¹ Department of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
² Department of Pathology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
³ Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.

Abstract

A 72-year-old female presented with bilateral pulmonary nodules before undergoing surgery for hysteroptosis. Transbronchial biopsy did not lead to a definitive diagnosis. The right mass in the upper lobe was resected through video-assisted thoracic surgery. Pathological findings showed granulomatosis with polyangiitis. However, the patient was negative for serum proteinase 3-anti-neutrophil cytoplasmic antibody. Although the nodule in the left lower lobe progressed, the serum inflammatory reaction yielded negative results. Resection of the nodule in the left lower lobe revealed identical pathological findings with those of the right pulmonary mass. Following total hysterectomy for hysteroptosis, the pathological findings indicated granulomatosis with polyangiitis.

Keywords: Anti-neutrophil cytoplasmic antibody-negative; Female genital granulomatosis; Granulomatosis with polyangiitis.

Publication types

Case Reports