FINE-NEEDLE ASPIRATION CYTOLOGY OF PULMONARY WEGENERS GRANULOMATOSIS WITH BIOPSY CORRELATION - A REPORT OF 3 CASES

BACKGROUND: Pulmonary Wegener's granulomatosis frequently presents cli nically as ill-defined nodules on chest radiographs or computed tomogr aphic scans. With refinement of fine needle aspiration (FNA) cytology as a diagnostic tool, pathologists are sometimes asked to render this diagnosis on cytologic material rather than on the more invasive open lung biopsy. Experience is currently limited to a few case reports in the cytopathology literature. We add to this by reporting the findings from five FNA biopsies performed on three patients, with open lung bi opsy correlation. CASES: The cytologic findings included a background of necrotic debris, acute and chronic inflammatory cells, multinucleat e giant cells and, in one case (case 2), numerous clusters of atypical epithelioid cells mimicking carcinoma. Correlation of the respective open lung biopsy specimens with the FNA material was instructive in re vealing the nature of the findings on cytologic preparations. Two case s showed classic histopathologic findings. Case 3 showed a less common presentation, pulmonary hemorrhage, which was reflected in the FNA sp ecimen. CONCLUSION: FNA biopsy cytology is a useful alternative to ope n lung biopsy in the diagnosis of pulmonary Wegener's granulomatosis b ut requires careful correlation with the clinical and laboratory findi ngs.