Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2021; 9(6): 1433-1438
Published online Feb 26, 2021. doi: 10.12998/wjcc.v9.i6.1433
Unusual presentation of granulomatosis with polyangiitis causing periaortitis and consequent subclavian steal syndrome: A case report
Uiju Cho, Sung-Kyung Kim, Jeong Min Ko, Jinyoung Yoo
Uiju Cho, Department of Pathology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea
Sung-Kyung Kim, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea
Jeong Min Ko, Department of Radiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea
Jinyoung Yoo, Department of Hospital Pathology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea
Author contributions: Cho U and Yoo J performed the pathologic examination and diagnosed the patient’s case, reviewed the literature and contributed to manuscript drafting; Kim SK was the patient’s physician and contributed to manuscript drafting; Ko J performed the radiologic analysis of the patient’s case and contributed to manuscript drafting; all authors issued final approval for the version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jinyoung Yoo, MD, PhD, Doctor, Professor, Department of Hospital Pathology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Ji-dong 93, Paldal-gu, Seoul 06591, South Korea. jinyyoo@catholic.ac.kr
Received: October 7, 2020
Peer-review started: October 7, 2020
First decision: December 21, 2020
Revised: December 30, 2020
Accepted: January 8, 2021
Article in press: January 8, 2021
Published online: February 26, 2021
Core Tip

Core Tip: Granulomatosis with polyangiitis (GPA) is a systemic process characterized by necrotizing vasculitis and granulomatous inflammation. The large vessel involvement by GPA is not only rare but also causes major diagnostic difficulty. We present a rare case of GPA, showing both lung and periaortic lesion in a male patient. Periaortic lesion of the patient caused vascular occlusion and consequent subclavian vein syndrome. On pathologic examination, the lung nodules had typical histologic features of GPA. This case reminds us that the GPA should not be excluded from the diagnosis because of a large vascular lesion present in an otherwise suspicious setting.