S15C3P1-Wegener's Granulomatosis

S15C3P1-1: This pulmonary lesion of Wegener’s granulomatosis shows a central rounded area outlined by green arrows. There is a central defect containing neutrophils. The neighboring lung shows interstitial fibrosis with a reduction in the size of air spaces. The central area outlined by green arrows is interpreted as a vessel that has been mostly destroyed by the suppurative necrosis of Wegener’s granulomatosis.
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S15C3P1-2: At higher magnification, there are scattered spindle cells that are interpreted as representatives of the smooth muscle cells of the muscularis of a small muscular artery.

S15C3P1-3: A pulmonary vessel is focally aneurysmal. Its wall shows fibrinoid necrosis. There are zones of suppurative necrosis adjacent to the damaged vessel.

S15C3P1-4: A partially destroyed vessel extends from the center of the field to the left, and upward. Its wall shows zones of fibrinoid necrosis. At the bottom of the field, there is a zone of fibrinoid and suppurative necrosis.

S15C3P1-5: A small vessel (green arrows) shows an area of fibrinoid necrosis. There is a zone of necrosis below the center of the field. There are scattered multinucleated giant cells in the neighboring inflammatory infiltrates.

S15C3P1-6: To the right, particularly near the bottom of the field, there is a zone of palisaded histiocytes. To the left of this zone, the pattern is that of inflamed granulation tissue with scattered, ill-defined collections of epithelioid histiocytes.

 

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