A 23-year-old man presents with a soft tissue mass in the left side of the abdomen. The patient doe not have any history of malignancy and the only relevant clinical history is that of long standing asthma. Surgical excision of the mass is performed.
Correct answer: B – Churg-Strauss syndrome
Churg-Strauss syndrome is also known as allergic angiitis and granulomatosis (AAG). There is no definitive etiology for this condition, but it probably represents an autoimmune process. The process may involve any organ system. Usually, patients with Churg-Strauss have a history of asthma. It is highly important to correlate the histological finding with the laboratory results, which may show blood eosinophilia, leukocytosis, and elevated erythrocyte sedimentation rate. In addition, perinuclear anti-neutrophil cytoplasmic antibodies are commonly positive, while cytoplasmic antineutrophil cytoplasmic antibodies are commonly negative. On histology alone, Churg-Strauss can be confused with granulomatosis with polyangiitis (formerly called Wegener's granulomatosis) or infectious diseases. Steroids are the treatment commonly used for these patients; however, some patients do not respond and may follow a more aggressive course.