Document Detail

Atypical squamous cells as a diagnostic pitfall in pulmonary Wegener's granulomatosis. A case report.
MedLine Citation:
PMID:  12040656     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Wegener's granulomatosis (WG) is characterized by systemic, necrotizing, granulomatous inflammation accompanied by vasculitis. It classically involves the triad of the upper respiratory tract, lungs and kidneys. Isolated pulmonary lesions of WG may present in some patients as pulmonary masses, simulating neoplasms. The features of WG can be suggested by cytologic study. Atypical epithelial cells associated with WG have previously been reported as a cause of a false positive diagnosis of bronchoalveolar carcinoma. CASE: In this case the cytologic findings included atypical squamous cells in a background of acute, chronic and granulomatous inflammation. In several respiratory specimens the atypical squamous cells were incorrectly interpreted as diagnostic of squamous cell carcinoma. The correct diagnosis of WG was confirmed with open lung biopsy, which demonstrated necrotizing granulomatous inflammation with geographic necrosis and associated vasculitis. CONCLUSION: Markedly atypical squamous cells mimicking squamous cell carcinoma can be found accompanying the inflammatory process associated with WG and are a possible diagnostic pitfall. The possibility of WG as well as other inflammatory processes should always be considered in the differential diagnosis of squamous cell carcinoma of the lung. This case is the only reported case of WG in which atypical squamous cells were a diagnostic pitfall, initially suggesting a diagnosis of squamous cell carcinoma.
John D Williamson; Sidney S Murphree; Lisa Wills-Frank
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Acta cytologica     Volume:  46     ISSN:  0001-5547     ISO Abbreviation:  Acta Cytol.     Publication Date:    2002 May-Jun
Date Detail:
Created Date:  2002-06-03     Completed Date:  2002-06-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370307     Medline TA:  Acta Cytol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  571-6     Citation Subset:  IM    
Department of Pathology, Norton Suburban Hospital, 4001 Dutchman's Lane, Louisville, Kentucky 40207, USA.
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MeSH Terms
Biopsy, Needle
Bronchoalveolar Lavage Fluid / cytology
Carcinoma, Squamous Cell / pathology
Diagnosis, Differential
Diagnostic Errors
Lung / pathology
Wegener Granulomatosis / pathology*

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