granulomatosis with polyangiitis histology shows necrotizing granulomas
- related: GPA granulomatosis with polyangitis Wegener
- tags: #literature #pulmonary
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The black arrows form a line of necrotizing inflammatory change. Yellow arrows point to nonnecrotizing granulomas. The green arrows point to giant cells.
The third option shows the presence of necrotizing and nonnecrotizing granulomas. Necrotizing granulomatous inflammation is often caused by infections, including mycobacterial infection, and nonnecrotizing granulomas are often associated with certain inflammatory conditions such as sarcoidosis. This photomicrograph (Figure 7) shows areas of nonnecrotizing granulomas (yellow arrows), necrotizing inflammation (in the region indicated by black arrows), as well as giant cells (green arrows) but does not reflect what would be expected for a patient with the radiographic and clinical history provided (eg, the case subject had a negative interferon-γ release assay), which is most congruent with silicosis. It is, however, important to recall that mycobacterial infections are closely associated with underlying silicosis and should be considered clinically as part of the evaluation process.
Granulomatosis with polyangiitis (previously referred to as Wegener granulomatosis) is typically associated with large areas of necrosis with irregular borders (so-called geographic necrosis). These areas of necrosis often take place in an inflammatory background, as shown in Figure 7. However, the history and radiographic features demonstrated in this case are not that of a patient with granulomatosis with polyangiitis.1