MULTİPL NODÜLLERLE SEYREDEN, AKCİĞER METASTAZINI TAKLİT EDEN ANCA(+) KOLLAJEN DOKU HASTALIĞI: OLGU SUNUMU

Öz

Multipl pulmoner nodüller, bir yada iki akciğerde sağlam akciğer dokusuyla çevrelenmiş, iyi sınırlı, birden çok, değişik şekillerde olabilen lezyonlardır. Multipl pulmoner nodüller genellikle metastatik oluşumlardır. Bir senedir devam eden kuru öksürük, halsizlik yakınmaları ile başvuran 46 yaşındaki bayan hastanın toraks bilgisayarlı tomografisinde (BT), bilateral parenkimde multipl nodüller izlendi. Metastatik akciğer hastalığı düşünülen hastada toraks dışı malignite açısından PET-BT istendi. Tanı amaçlı yapılan BT eşliğinde transtorasik ince iğne aspirasyon biyopsisinin sitolojik incelemesinin benign gelmesi üzerine hastaya video yardımlı torakoskopik cerrahi (VATS) uygulandı. Nodüllerin histopatolojik inceleme sonucu granulomatöz anjitis olarak değerlendirildi. Gönderilen romatolojik markırlardan P-ANCA ve ANA pozitif olması üzerine romatoloji ile konsülte edildi ve ANCA (+) kollajen doku hastalığı tanısı konuldu. Siklofosfamid ve steroid tedavisi verilerek akciğer nodüllerinde regresyon izlenen hasta literatür eşliğinde sunuldu.

Anahtar Kelimeler

• Multipl, pulmoner nodül, ANCA

ANCA (+) COLLAGEN TİSSUE DİSEASE CHARACTERİZED BY MULTİPLE PULMONARY NODULES IMİTATİNG LUNG CANCER: CASE REPORT

Abstract

Multiple pulmonary nodules are lesions that can be multiple, well-defined, in different forms and surrounded by a healthy lung tissue at one or two lungs. Multiple pulmonary nodules are usually metastatic growths. At bilateral parenchyma multiple nodules are viewed on the chest computed tomography (CT) of 46-year-old female patient who had the complaints of fatigue, dry cough during one year. Patients that is considered with metastatic lung disease, was asked PET-CT for the extrathoracic malignancy. When for diagnose, cytological examination of the CT-guided transthoracic fine needle aspiration biopsy was negative, video-assisted thoracoscopic surgery (VATS) was performed. Granulomatous angitis were evaluated as a result of nodules histopathological examination. When P-ANCA and ANA of the sending rheumatologic markers was positive, the patient was consulted with rheumatology and ANCA (+) connective tissue disease were diagnosed. The patient who was seen regression patient's lung nodules with cyclophosphamide and steroid treatment, is presented with literature.

Keywords

• Multiple, pulmonary nodule, ANCA

Kaynakça

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