Granulomatosis with polyangiitis (wegener’ s granulomatosis) diagnosed by transbronchial biopsy from stenotic portion of mainstem bronchus

This report concerns a case of granulomatosis with polyangiitis (GPA) (Wegener’ s granulomatosis (WG)) with bronchus narrowing. Although nasal biopsy had been performed three times, no positive histology for GPA (WG) could be obtained. Flexible bronchoscopy revealed diff use erythema, edema of the mucosa and stenosis of the right main stem bronchus. Transbronchial biopsy identified granuloma with giant cells. These findings led to a diagnosis of GPA (WG). This case suggests that biopsy from the bronchus is useful for diagnosis of GPA (WG).