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Immunohistochemical Characterization Of Granulomatosis With Polyangiitis Exhibiting Spontaneous Regression

Masuta, Y. 2024Other/Unknown

Masuta, Y., Komeda, Y., Sekai, I., Hara, A., Kurimoto, M., Yoshikawa, K., Otsuka, Y., Takada, R., Yoshikawa, T., Kamata, K., Minaga, K., Maenishi, O., Watanabe, T., & Kudo, M. (2024). Immunohistochemical characterization of granulomatosis with polyangiitis exhibiting spontaneous regression. Asian Pacific journal of allergy and immunology, 42(4), 415–419. https://doi.org/10.12932/AP-190221-1073

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Abstract

BACKGROUND: Granulomatosis with polyangiitis (GPA) is characterized by granulomatous inflammation, vasculitis, and elevated levels of serum proteinase 3 (PR3)-anti-neutrophil cytoplasmic antibody (PR3-ANCA). OBJECTIVE: We tried to characterize immune cells accumulated into the lung lesions of a GPA patient exhibiting spontaneous regression. METHODS: Transbronchial lung biopsy (TBLB) samples were subjected to immunohistochemical analyses. RESULTS: Multiple lung nodules were detected by CT. TBLB showed granulomatous inflammation and small vessel vasculitis. This case was diagnosed as GPA based on pathological findings and elevation of PR-3 ANCA levels. Spontaneous disappearance of multiple lung nodules was observed in CT. CD3+ T cells and CD20+ B cells accumulated in the inflammatory lesions surrounding the vessels whereas granulomatous inflammation was mainly comprised of CD3+ T cells and CD68+ macrophages, but not B cells or myeloperoxidase+ neutrophils. CONCLUSIONS: We characterized immune cell compositions of the lung lesions of a patient with GPA exhibiting spontaneous regression.

Case Details

Disease Location

Lung

Personal Characteristics

24-year-old-man

Clinical Characteristics

Multiple nodules localized in the bilateral peripheral lungs were detected in lung CT. Transbronchial lung biopsy (tblb) against the right s8 lung nodule was performed. Granulomatous inflammation, deposition of fibrinoid materials, stenosis of the vascular lumen, and infiltration of immune cells surrounding the small vessels were observed. The patient was diagnosed with granulomatosis with polyangiitis (gpa)

Remission Characteristics

Multiple lung nodules completely disappeared four months later in follow-up CT

Treatment & Mechanisms

Clinical Treatment

Biopsy