WEGENERS GRANULOMATOSIS IN CHILDREN - CHEST RADIOGRAPHIC MANIFESTATIONS

OBJECTIVE. The purpose of this study was to review the findings on che st radiographs in children with Wegener's granulomatosis. MATERIALS AN D METHODS. The chest radiographs in 11 children with histologically pr oved Wegener's granulomatosis were retrospectively reviewed. The radio graphs were evaluated for the presence of focal opacities, diffuse int erstitial or alveolar opacities, nodular densities, cavitary lesions, hilar or mediastinal enlargement suggesting adenopathy, pleural fluid, and calcifications. RESULTS. Two children had normal findings on ches t radiographs. One child had a focal opacity that developed into a lar ge, thick-walled cavitary lesion, and one child had small bilateral no dules, several of which cavitated. Seven children had diffuse intersti tial or alveolar opacities, five of whom had pathologically proved pul monary hemorrhages. In one of these seven children, a thin-walled cavi ty subsequently developed. Pleural effusions were present in two child ren, one with pulmonary hemorrhage and one with pulmonary edema. No ly mph node enlargement or calcifications were observed in any of our cas es. CONCLUSIONS. Diffuse interstitial and alveolar opacities are the m ost common pulmonary findings in children with Wegener's granulomatosi s, often secondary to pulmonary hemorrhage. Pulmonary nodules, with or without cavities, are less common findings in children.