Granülamatosis Polianjitis tanılı beş olgunun Pozitron Emisyon Tomografisi ile değerlendirilmesi

Year 2017, Volume: 8 Issue: 2, 76 - 80, 08.06.2017

Nalan Ogan , Nilgün Yılmaz Demirci Funda Demirbağ Yurdanur Erdoğan

https://doi.org/10.18663/tjcl.320049

Cited By: 1

Abstract

Granülomatöz Polianjitis (GPA) eski
adıyla Wegener Granülomatozu, öncelikle üst solunum yolları, akciğer ve
böbrekleri tutan, granülomatöz nekrotizan vaskülit ile karakterizedir. Hastalığın
'sınırlı' ve 'yaygın' olmak üzere iki formu vardır. Radyolojik bulguları birkaç
milimetreden santimetreye kadar değişen çok sayıda bilateral nodüller veya
parankimal infiltrasyonlar, kavitasyonlar veya kavitasyonlarla karakterize
nodüller olarak görülür. Bu nodüller bazen boyut ve görünüm açısından malignite
ile karışabilir. Bu çalışmada, maligniteyi taklit eden GPA tanısı alan 5
olgunun ilk değerlendirmesinde pozitron emisyon tomografisi / bilgisayarlı
tomografinin (PET / BT) rolünü tartışmayı amaçladık.

Keywords

Wegener Granülomatozu, akciğer, böbrek, pozitron emisyon tomografisi

Positron Emission Tomography in the management of five cases with granulomatosis with polyangiitis

Abstract

Granulomatosis
with polyangiitis (GPA) formerly Wegener’s
Granulomatosis, is characterized by granulomatosis necrotizing vasculitis that
primarily involves upper respiratory tracts, lung and kidney. There are two
types of disease, ‘limited’ and ‘generalized’. Radiological findings are seen
as multiple bilateral nodules that change from a few millimeters to centimeters
in size or parenchymal infiltrations, cavitations or nodules
presented with cavitations. These nodules sometimes can be confused with
malignancy in terms of the size and appearance. In this study, we discussed the role of positron emission
tomography/computerized tomography (PET/CT) in the initial evaluation of
patients with the
diagnosis of GPA mimicking malignancy.

Keywords

Wegener’s Granulomatosis, lung, kidney

References

• 1. Falk RJ, Jennette JC. ANCA disease: where is this field going? J Am Soc Nephrol 2010; 21: 745–52.
• 2. Schilder AM. Wegener's granulomatosis vasculitis and granuloma. Autoimmun Rev 2010; 9: 483-7.
• 3. Rubin LJ. Pulmonary vasculitis and primary pulmonary hypertension. In: Murray JF, Nadel JA (eds). Texbook of Respiratory Medicine. Philadelphia: WB Saunders Company, 2000: 1533-56.
• 4. Leavitt RY, Fauci AS, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Wegener’s granulomatozis. Arthritis Rheum 1990; 33: 1101-7.
• 5. Gungor O, Turan N M, Tatar E, et al. Akciğer tümörünü taklit eden Wegener granülomatozu. Ege Jour Med 2013; 52: 160-2.
• 6. Hoffman GS, Kerr GS, Leavitt RY, et al. Wegener granulomatosis: An analysis of 158 patients. Ann Intern Med 1992; 116: 488-98.
• 7. DeRemee RA. Pulmonary vasculitis. In: Fishman AP(ed). Fishman’s Pulmonary Diseases and Disorders. NewYork: McGraw-Hill, 1997: 1357-74.
• 8. Imdahl A, Jenkner S, Brink I, et al. Validation of FDG positron emission tomography for differentiation of unknown pulmonary lesions. Eur J Cardiothorac Surg 2001: 20: 324-9.
• 9. Yamada S, Kubota K, Kubota R, Ido T, Tamahashi N. High accumulation of fluorine-18-fluorodeoxyglucose in turpentine-induced inflammatory tissue. J Nucl Med 1995; 36: 1301–6.
• 10. Kaim AH, Weber B, Kurrer MO, Gottschalk J, Von Schulthess GK, Buck A. Autoradiographic quantification of 18F-FDG uptake in experimental soft-tissue abscesses in rats. Radiology 2002; 223: 446–51.
• 11. Bambery P, Kataria S, Sakhuja V, et al. Wegener’s granulomatosis in North India. Radiologic manifestations in eleven patients. Acta Radiologica 1988: 29:11-3.
• 12. Woywodt A, Matteson EL. Wegener’s granulomatosis-probing the untold past of the man behind the eponym. Rheumatology (Oxford). 2006; 45: 1303-6.
• 13. Nuyts GD, Van Vlem E, De Vos A, et al. Wegener granulomatosis is associated to exposure to silicon compounds: a case-control study. Nephrology, Dialysis, Transplantation 1995; 10: 1162-5.
• 14. Carol AL, Gary SH. Wegener’s granulomatosis. Thorax 1999; 54: 629-37.
• 15. Takwoingi YM, Dempster JH. Wegener’s granulomatosis: an analysis of 33 patients seen over a 10-year period. Clin Otolaryngol 2003; 28: 187.
• 16. Jennings CR, Jones NS, Dugar J, Powell RJ, Lowe J Wegener’s granulomatosis, a review of diagnosis and treatment in 53 subjects. Rhinology 1998; 36:188-91.
• 17. Savage CO, Harper L, Adu D. Primary systemic vasculitis. Lancet 1997; 49: 553-8.
• 18. Travis WD, Fleming MV. Vasculitis of the lung. Pathology 1996; 4: 23-41.
• 19. Fauci AS. The vasculitis syndroms. In: Wilson JD, Brounwald E, Isselbacher KJ (eds). Harrisons Principles of Internal Medicine. New York: Mc Graw-Hill, 1991: 456-63.
• 20. Fraser RS, M.ller NL, Colman N, Par. PD. Diagnosis of diseases of the chest. 4th ed. Saunders Company. USA. 1999: 1489-532.
• 21. Pretorius ES, Stone JH, Hellmann DB, Fishman EK. Wegener’s granulomatosis: spectrum of CT findings in diagnosis, disease progression, and response to therapy. Crit Rev Diagn Imaging 2000; 41: 279-313.
• 22. Seo P, Stone JH. The antineutrophil cytoplasmic antibody-associated vasculitides. Am J Med 2004; 117: 39-50.
• 23. Maranhao AS, Chen VG, Rossini BA, Testa JR, Penido Nde O. Mastoiditis and facial paralysis as initial manifestations of Wegener’s granulomatosis. Braz J Otorhinolaryngol 2012; 78: 80-6.
• 24. Sacco O, Fregonese B, Gambini C, et al. Rapidly progressing pulmonary nodules in a 14 yrs old boy. Clin Imaging 1998; 22: 99-104.
• 25. Beggs AD, Hain SF. F-18 FDG-positron emission tomographic scanning and Wegener’s granulomatosis. Clin Nucl Med 2002; 27: 705-6.
• 26. Walter MA, Melzer RA, Schindler C, Müller-Brand J, Tyndall A, Nitzshe EU. The value of [18F] FDG-PET in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease. Eur J Nucl Med Mol Imaging 2005; 32: 674-81.
• 27. Bertagna F, Bosio G, Caobelli F, Motta F, Biasiotto G, Giubbini R. Role of 18F-fluorodeoxyglucose positron emission tomography / computed tomography for therapy evaluation of patients with large-vessel vasculitis. Jpn J Radiol 2010; 28: 199–204.
• 28. Bleeker-Rovers CP, Bredie SJ, van der Meer JW, Corstens FH, Oyen WJ. Fluorine 18 fluorodeoxyglucose positron emission tomography in the diagnosis and follow-up of three patients with vasculitis. Am J Med 2004; 116: 50–3.
• 29. Blockmans D, Stroobants S, Maes A, Mortelmans L. Positron emission tomography in giant cell arteritis and polymyalgia rheumatica: evidence for inflammation of the aortic arch. Am J Med 2000; 108: 246–9.
• 30. Ito K, Minamimoto R, Yamashita H, et al. Evaluation of Wegener’s granulomatosis using 18F-fluorodeoxyglucose positron emission tomography/computed tomography. Ann Nucl Med 2013; 27: 209-16.
• 31. Ozmen O, Tatci E, Gokcek A, et al. Integration of 2-deoxy-2-[18F] fluoro-D-glucose PET/CT into clinical management of patients with Wegener’s granulomatosis. Ann Nucl Med 2013; 27: 907-15.