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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제60권 제5호
발행연도
2019.1
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454 - 460 (7page)

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Purpose: The present study investigated chest computed tomography (CT) patterns and lung histological features, as well as theconsistency between radiological and histological features among patients with microscopic polyangiitis (MPA), granulomatosiswith polyangiitis (GPA), and eosinophilic GPA (EGPA). Materials and Methods: The medical records of 74 antineutrophil cytoplasmic antibody-associated vasculitis (AAV) patients withradiological lung parenchymal lesions were reviewed along with the histological results for 28 of them. Chest CT patterns were dividedaccording 12 items mostly suggested by radiologists and histological features were divided according to necrotising granuloma,necrotising vasculitis, eosinophilic infiltration, and hemosiderin laden macrophages as defined by a pathologist. Results: The mean age was 57.1 years (22 men). The most common clinical manifestation other than lung manifestation was renalmanifestation (62.2%), and the most common chest CT pattern was lung involvement of vasculitis (35.1%). In MPA patients, the majorhistological features were hemosiderin-laden macrophages in the alveolar space and vasculitis. In GPA patients, the major histologicalfeatures were necrotizing vasculitis and necrotizing granuloma, while in EGPA patients, the major histological feature wasonly necrotising vasculitis. The consistency rate in GPA patients was the highest (100%), followed by that in MPA patients (66.7%)and EGPA patients (50.0%). Conclusion: When lung involvement of AAV is suspected on chest CT, lung biopsy should be recommended for the proper classificationof AAV, due to the discordance rate between radiological and histological findings in MPA and EGPA patients, but not GPApatients.

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