Skip to main content
Top
Published in:

Open Access 22-04-2024 | Lung Cancer | Case Report

Lung cancer in older patients with granulomatosis with polyangiitis: a report of three cases

Authors: Malgorzata Potentas-Policewicz, Malgorzata Szolkowska, Katarzyna Blasinska, Dariusz Gawryluk, Malgorzata Sobiecka, Justyna Fijolek

Published in: BMC Pulmonary Medicine | Issue 1/2024

Login to get access

Abstract

Background

Granulomatosis with polyangiitis (GPA) is characterized by necrotizing granulomatous inflammation with necrotizing vasculitis predominantly affecting small to medium vessels. The survival rates have drastically improved; however, GPA can be lethal, with older patients having a worse prognosis and higher mortality than younger patients. Moreover, the incidence of various cancers has been reported to increase in patients with GPA. We aimed to discuss possible associations between GPA and lung cancer and emphasize the associated diagnostic challenges.

Case presentation

We encountered three older patients with chronic GPA who developed lung cancer during long-term follow-up. Two of the patients had a smoking history, with one having silicosis and the other having chronic obstructive pulmonary disease. Furthermore, all of them had radiation exposure from repeated radiography/computed tomography. All the patients had confirmed GPA, and vasculitis relapse was first suspected when new lung lesions were noted during follow-up. However, they had no new clinical symptoms, and serum ANCA titer increased only in one patient. All the patients received standard immunosuppressive treatment but eventually died.

Conclusions

Lung cancer is uncommon in patients with GPA; however, the similarity between the imaging findings of lung cancer and GPA may pose a diagnostic challenge. Clinicians should be particularly vigilant when treating older patients with an increased risk of cancer, as they are often asymptomatic or have poorly apparent clinical features.
Literature
4.
go back to reference Faurschou M, Sorensen IJ, Mellemkjaer L, Loft AGR, Thomsen BS, Tvede N, et al. Malignancies in Wegener’s granulomatosis: incidence and relations to cyclophosphamide therapy in a cohort of 293 patients. J Rheumatol. 2008;35:100–5.PubMed Faurschou M, Sorensen IJ, Mellemkjaer L, Loft AGR, Thomsen BS, Tvede N, et al. Malignancies in Wegener’s granulomatosis: incidence and relations to cyclophosphamide therapy in a cohort of 293 patients. J Rheumatol. 2008;35:100–5.PubMed
10.
11.
go back to reference Andino R, Hernandez Y, Monasterio F, Bernis C. Wegener granulomatosis and cancer. Nefrologia. 2008;28:232. Andino R, Hernandez Y, Monasterio F, Bernis C. Wegener granulomatosis and cancer. Nefrologia. 2008;28:232.
14.
17.
go back to reference Xie C, Stoddart C, Bewes J, Peschl H, Luqmani R, Benamore R. A hidden lung cancer in a patient with granulomatosis with polyangiitis. BJR Case Rep. 2020;6:20190114.PubMedPubMedCentral Xie C, Stoddart C, Bewes J, Peschl H, Luqmani R, Benamore R. A hidden lung cancer in a patient with granulomatosis with polyangiitis. BJR Case Rep. 2020;6:20190114.PubMedPubMedCentral
20.
go back to reference Pugh D, Farrah TE, Gallacher PJ, Kluth DC, Dhaun N. Cyclophosphamide- induced lung injury. Kidney Int Rep. 2019;4:484–6.CrossRefPubMed Pugh D, Farrah TE, Gallacher PJ, Kluth DC, Dhaun N. Cyclophosphamide- induced lung injury. Kidney Int Rep. 2019;4:484–6.CrossRefPubMed
Metadata
Title
Lung cancer in older patients with granulomatosis with polyangiitis: a report of three cases
Authors
Malgorzata Potentas-Policewicz
Malgorzata Szolkowska
Katarzyna Blasinska
Dariusz Gawryluk
Malgorzata Sobiecka
Justyna Fijolek
Publication date
22-04-2024

Other articles of this Issue 1/2024

BMC Pulmonary Medicine 1/2024 Go to the issue