Solitary Bronchial Ulcer in Limited Wegenerʼs Granulomatosis

Abstract

We report a case of a limited form of Wegener's granulomatosis with an instructive bronchoscopic finding. A 59− year-old asymptomatic man underwent thoracic surgery for resection of a solitary lung mass. Histopathology showed necrotizing granulomas. Fifteen months later, nasal symptoms arose and a diagnosis of Wegener's granulomatosis was made by nasal mucosal biopsy and blood examination (c-ANCA positive). Simultaneously, a solitary bronchial ulcer was detected in the truncus intermedius on bronchoscopy. but no recurrence of lung parenchymal lesions (including the area adjacent to the right hilum) was found. Tracheobronchial involvement by Wegener's granulomatosis is well known, but usually it is part of severe, progressive disease and is related to surrounding parenchymal lesions. However, the present case shows that a localized and mild endobronchial lesion can be seen on bronchoscopic examination in Wegener's granulomatosis.