title: [A case of Behçet disease with multiple nodular shadows and aneurysm of the brachiocephalic trunk caused by necrotizing vasculitis].
abstract: A 36-year-old man was admitted to our hospital in 1994 because of fever, and abdominal CT showed multiple low-density areas in the liver. Although granulomas were found in a liver biopsy specimen, a definitive diagnosis could not be established. With complaints of oral and genital ulcerations and erythema nodosum, Behçet disease was diagnosed in 1995 and he was treated with colchicine and cyclosporin. In May 1997 he had fever, leg edema, and proteinuria, and a renal biopsy revealed secondary amyloidosis. Cavitary lesions were found on a chest X-ray for the first time, but these later disappeared spontaneously. In October 2002, nodular shadows, cavitary lesions, and a mediastinal tumor appeared on a chest X-ray film. The nodular shadows in the lung fields had transformed into cavity lesions, resulting in the disappearance of the shadows. Specimens obtained from an open lung biopsy showed necrotizing granulomas and destructive vasculitis of the lung, and aneurysm of the brachiocephalic trunk caused by destructive vasculitis. Because multiple nodular shadows with cavitary lesions in Behçet disease, as in this case, have never been reported, we think this is a rare case.
authors.affiliation: Department of Respiratory Disease, Nagoya Daini Red Cross Hospital.
authors.forename: Eishi
authors.initials: E
authors.lastname: Kato
authors.forename: Yuka
authors.initials: Y
authors.lastname: Isobe
authors.forename: Akiko
authors.initials: A
authors.lastname: Mizuno
authors.forename: Hisashi
authors.initials: H
authors.lastname: Wakayama
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Ogasawara
authors.forename: Masayuki
authors.initials: M
authors.lastname: Suzuki
authors.forename: Shigeki
authors.initials: S
authors.lastname: Shimizu
authors.forename: Takashi
authors.initials: T
authors.lastname: Niimi
authors.forename: Shigeki
authors.initials: S
authors.lastname: Sato
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Ueda
mesh_terms: D000783:Aneurysm / Q000209:etiology*; D001528:Behcet Syndrome / Q000150:complications* / Q000000981:diagnostic imaging; D001706:Biopsy; D016122:Brachiocephalic Trunk; D006099:Granuloma / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008168:Lung / Q000473:pathology; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000473:pathology; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D014657:Vasculitis / Q000150:complications* / Q000473:pathology