case_images: PMC10593167_01
case_images: CTA of the chest (1A and 1B) demonstrating a large anterior left upper lobe consolidation.
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case_images: f1-jchim-13-03-103
case_images: Computed tomography (CT) angiography of the chest with contrast showed no pulmonary embolism, but demonstrated an anterior left upper lobe (LUL) consolidation (Fig. 1).
case_images: Transthoracic echocardiogram demonstrating a moderate-large pericardial effusion with tamponade physiology (A and B).
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case_images: PMC10593167_01_jchim-13-03-103f2.jpg
case_images: f2-jchim-13-03-103
case_images: Transthoracic echocardiogram showed ejection fraction 60-65%, peak pulmonary artery pressure of 61 mmHg, and a moderate-large pericardial effusion with tamponade physiology (Fig. 2).
case_images: Lung biopsy findings consistent with GPA, with the arrows demonstrating granulomatous inflammation (3A) containing multinucleated giant cells (3B), fibrinoid necrosis with angiocentric and angioinvasive patterns of vasculitis (3C), and geographic necrosis with a basophilic smudgy appearance (3D). Hematoxylin-eosin stain with magnification x10.
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case_images: PMC10593167_01_jchim-13-03-103f3.jpg
case_images: f3-jchim-13-03-103
case_images: Lung biopsy from previous visit underwent evaluation at outside facility which reported irregular zones of necrotizing granulomatous inflammation and diffuse pulmonary capillaritis, consistent with GPA (Fig. 3).