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Clinical Problem Solving: Pathology
October 2003

Pathology Quiz Case

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2003;129(10):1135-1136. doi:10.1001/archotol.129.10.1135

A 71-YEAR-OLD woman presented with a 3-year history of intractable nasal blockage with fetid purulent discharge, accompanied by intermittent blood-tinged postnasal dripping and low-grade fever. She denied weight loss or cold sweating. Nasal Wegener granulomatosis (WG) was diagnosed at another medical center because the findings of a nasal biopsy were thought to be consistent with that diagnosis, although the results of cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA) tests were negative. After receiving steroid therapy, without relief of symptoms, the patient was referred to our center for further evaluation and treatment.

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