title: Granulomatosis with polyangiitis presenting as a renal tumor.
abstract: Inflammatory tumors of the kidney are uncommon and include primary inflammatory processes and systemic diseases such as sarcoidosis, IgG4 disease, and granulomatosis with polyangiitis (GPA). There are approximately 15 cases of the latter in the literature. Tumors in GPA are well described and have been reported in several organs including breast, orbit, mediastinum, central nervous system, and especially the lung. We report the case of a 48-year-old woman who presented with diffuse frontal headaches. Imaging showed both a cranial/sinus and renal mass. The pathology of the dura and nasal sinus biopsies were unrevealing. A nephrectomy was performed that demonstrated a discrete lesion with extensive necrosis, granulomatous inflammation, and crescentic pauci-immune glomerulonephritis, findings consistent with GPA.
authors.affiliation: Departments of *Pathology †Rheumatology, Harvard Medical School, Beth Israel Deaconess Medical Center ‡Department of Pathology, Harvard Medical School Massachusetts General Hospital, Boston, MA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Ward
authors.forename: Christine
authors.initials: C
authors.lastname: Konya
authors.forename: Eugene J
authors.initials: EJ
authors.lastname: Mark
authors.forename: Seymour
authors.initials: S
authors.lastname: Rosen
mesh_terms: D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D005260:Female; D005921:Glomerulonephritis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D006104:Granuloma, Plasma Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000000981:diagnostic imaging / Q000187:drug effects / Q000276:immunology* / Q000473:pathology; D007674:Kidney Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009336:Necrosis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D007166:Immunosuppressive Agents