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Case No. 624
2022-06-01~2022-06-30
출제자 : 이경식
Hit : 389
| Period | 2022-06-01~2022-06-30 |
|---|---|
| Diagnosis | Sinonasal Wegener’s granulomatosis (Granulomatosis with polyangiitis) |
| Gender |
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| Age | 79 |
| Clinical information | 문제 1. 3개월 전부터 누런 코가 나오고 코막힘이 심했졌으며, 최근 청력도 감소하여 내원한 79세 남자환자의 CT 영상입니다. 가능한 진단은? |
| Discussion | Etiology: multi-system systemic necrotizing non-caseating granulomatous vasculitis affecting small to medium-sized arteries, capillaries and veins. Imaging feature: 1) NECT - Chronic rhinosinusitis with localized mucosal nodularity and masses centered in nasal cavity - Periantral soft tissue infiltration - Chronic obstruction and inflammation of adjacent sinuses may result in nonspecific hyperostosis of sinus walls - Osseous/cartilaginous erosion often affects nasal septum primarily, causing perforation - Destruction then involves turbinates and lateral nasal wall (uncinate process and medial wall maxillary sinus) - May affect hard palate leading to sinonasal-oral fistula 2) CECT - Enhancing nodular and mass-like mucosal thickening |
| Correct answer |
Correct Answer
Semi-Correct Answer |