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An unusual presentation of Wegener’s granulomatosis mimicking thymoma
  1. C-R Wang1,
  2. J-M Chang2,
  3. W-L Shen3,
  4. W-J Lin4,
  5. J Y-Y Lee5,
  6. M-F Liu1
  1. 1Section of Rheumatology, Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
  2. 2Section of Thoracic Surgery, Department of Surgery, College of Medicine, National Cheng Kung University, Tainan, Taiwan
  3. 3Department of Pathology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
  4. 4Section of Pulmonary Medicine, Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
  5. 5Department of Dermatology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
  1. Correspondence to:
    Dr C-R Wang
    wangcrmail.ncku.edu.tw

https://doi.org/10.1136/ard.2004.031617

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    Pulmonary manifestations of Wegener’s granulomatosis (WG) range from asymptomatic nodules, fleeting infiltrates to alveolar haemorrhage.1 A mediastinal mass was considered an unlikely feature of WG and its presence was regarded as an alternative diagnosis.2 We report on a patient with WG who presented with a mediastinal mass and an elevation of the left hemidiaphragm, initially thought to be thymoma. Thymectomy disclosed extensive inflammation composed of necrotising vasculitis and extravascular granuloma. To our knowledge, this unusual presentation of WG mimicking thymoma has not been reported previously.

    CASE REPORT

    A 34 year old man was referred to our hospital with a thymic tumour. The patient had had vague chest pain for 1 year and, 3 weeks before admission, the pain became aggravated. There was no past history of allergic diseases such as bronchial asthma. At hospital chest radiography showed a wide mediastinum with an elevation of the left diaphragm (fig 1A⇓), and chest computed tomography (CT) …

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