Correct!
2. Granulomatosis with polyangiitis
All the choices could present with multiple pulmonary nodules, but there is also an enlarged mediastinum, concerning for a mediastinal mass/lymphadenopathy, which GPA typically doesn’t present with. The other three choices could have involvement of the mediastinum and differentiating between them solely on chest radiography is difficult, although septic emboli may be expected to show cavitation within some of the nodules, which is not present.
Contrast-enhanced thoracic CT (Figure 2) was performed for further evaluation of the findings seen at chest radiography.
Figure 2. Enhanced thoracic CT scan in lung windows.
The pulmonary nodules are identified as being solid with surrounding ground-glass opacity (CT halo sign). What classically does the halo represent? (Click on the correct answer to proceed to the third of five panels)