We present an unusual case of granulomatosis with polyangiitis (GPA), which initially presented as a large lung mass, without renal or other systemic features. The lung mass was most concerning for malignancy, and positron emission tomography (PET) further supported this concern, with intense uptake in the mass as well as in mediastinal and hilar lymph nodes. Biopsies however were non-diagnostic, and the patient developed acute kidney injury with active urinary sediment, leading to a definitive diagnosis of GPA. With supportive care and treatment directed at GPA, she was ultimately able to discontinue hemodialysis, and the lung mass resolved. This case demonstrates that GPA can present with PET-positive lymphadenopathy which may be initially suspected to be a malignancy, especially in the absence of renal abnormalities.
El-Yafawi, Rama; Cantlin, Patricia; and Van der Kloot, Thomas E.
"Increased 18F-FDG-PET Uptake in Granulomatosis with Polyangiitis: Case Report and Review of the Literature,"
Journal of Maine Medical Center: Vol. 1
, Article 10.
Available at: https://knowledgeconnection.mainehealth.org/jmmc/vol1/iss1/10