Pediatric Granulomatosis With Polyangiitis

  • Etiology: Small vessel vasculitis with necrotizing inflammation of small to medium sized vessels leading to end organ changes in sinuses, trachea, lungs, kidneys
  • Imaging:
    — Cavitary and non cavitary nodules
    — Airspace and ground glass consolidation
    — Reverse halo sign
    — Interstitial thickening – axial interstitial
  • DDX:
  • Complications:
  • Treatment:
  • Clinical: Clinical context and indolent signs and symptoms and multiorgan involvement are key in making diagnosis

Radiology Cases of Granulomatosis With Polyangiitis

CXR and CT of granulomatosis with polyangiitis
CXR AP and lateral (above) show bilateral thick walled cavitary nodules in the lungs. Axial CT with contrast of the chest (below) shows just how thick walled the cavitary nodules are in the left lung. Multiple smaller non-cavitary nodules are seen scattered throughout both lungs.
CXR and CT of granulomatosis with polyangiitis
CXR (above left) shows bilateral peripheral airspace disease that is more prevalent in the lower lobes than the upper lobes. Coronal (above right) and axial (below) CT with contrast of the chest better demonstrates the disease distribution and the presence of a few small non-cavitary nodules bilaterally.