Computed Tomography Features of the Thoracic Manifestations of Wegener Granulomatosis

Wegener granulomatosis is a multisystem disease of unknown etiology, characterized histologically by a necrotizing granulomatous vasculitis (Fig. 1). Although any organ system may be involved, the lungs, upper respiratory tract, and kidneys are the most commonly affected. Pulmonary involvement occurs at some stage of the disease process in almost all patients, and chest radiographic abnormalities develop in up to 85% (1). CT is superior to chest radiography in assessing the presence and extent of pulmonary parenchymal abnormalities in patients with Wegener granulomatosis (2). In this essay, we illustrate the characteristic CT findings of pulmonary Wegener’s granulomatosis and show some of the more unusual imaging features.