さまざまな副鼻腔病変を呈したＷｅｇｅｎｅｒ肉芽腫３例―ＣＴ所見の検討―

DOI Web Site 参考文献13件
  • 立山 香織
    大分大学免疫アレルギー統御講座（耳鼻咽喉科）
  • 児玉 悟
    大分大学免疫アレルギー統御講座（耳鼻咽喉科）
  • 前田 一彦
    大分大学免疫アレルギー統御講座（耳鼻咽喉科）
  • 安倍 伸幸
    大分大学免疫アレルギー統御講座（耳鼻咽喉科）
  • 能美 希
    大分大学免疫アレルギー統御講座（耳鼻咽喉科）
  • 鈴木 正志
    大分大学免疫アレルギー統御講座（耳鼻咽喉科）

書誌事項

タイトル別名
  • Computed Tomography Findings of Sinonasal Wegener's Granulomatosis
  • 臨床 さまざまな副鼻腔病変を呈したWegener肉芽腫3例--CT所見の検討
  • シンリョウ サマザマ ナ フクビクウ ビョウヘン オ テイシタ Wegener ニクゲシュ 3レイ CT ショケン ノ ケントウ
  • ―CT所見の検討―

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抄録

Wegener’s granulomatosis (WG) is a systemic vasculitis that can affect any organ. It is often difficult to diagnose at an early stage. Chronic sinusitis is a well-known clinical feature of the disease. We reviewed computed tomography (CT) findings in three cases of WG with sinonasal symptoms.<br> Case 1: A 33-year-old woman presented with choanal flow and recurrent epistaxis. CT findings revealed a ring-like calcification mimicking a fungus ball, in the right maxillary sinus. PR3-ANCA was positive. Biopsy was performed for the granulation in the right nasal cavity, and she was diagnosed as having WG.<br> Case 2: A 79-year-old woman who presented with right cheek pain. CT findings showed bone destruction of ethmoidal cells and bony thickening of the right maxillary sinus. Malignancy was ruled out histopathologically in endoscopic sinus surgery, but the pathology could not confirm the diagnosis of WG. Cheek pain and general fatigue persisted. Laboratory data showed elevated CRP and normal concentrations of PR3-ANCA. We clinically suspected WG and started steroid therapy. Symptoms immediately improved.<br> Case 3: A 59-year-old woman with acute right visual loss and exophthalmos. She had saddle nose deformity, and anterior rhinoscopy revealed the absence of both the middle and inferior turbinates and nasal septum. CT showed a soft tissue mass in the right orbit and new bone formation in the right maxillary sinus.<br> WG is difficult to diagnose at an early stage and when limited to the head and neck region. In our cases, CT in our cases showed mucosal changes, bone destruction and sclerosis, and an orbital mass. These CT findings may aid diagnosis at an early stage when clinical suspicion is high.<br>

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