Wegener's Granulomatosis in North India

The chest radiograph in Wegener's granulomatosis reveals several striking, but not pathognomonic abnormalities. Nine (82%) of eleven patients with Wegener's granulomatosis had abnormal chest radiographs. Infiltrates were seen in all patients and were nodular in seven (77%). Six patients had cavities which were most often unilateral and thick walled. Serial radiographs showed the simultaneous appearance and resolution of infiltrates in 4 of 7 instances. Bilateral pulmonary involvement (67%), pleural effusion (33%), and pericardial effusion (22%) were also seen. Paranasal sinus involvement was seen in 4 of 5 studies. The chest radiograph was interpreted as tuberculosis in eight patients, resulting in delayed diagnosis and incorrect treatment.