A male patient with cavitary pulmonary disease.

Granulomatosis with polyangiitis (Wegener) (GPA) was diagnosed in a 44 year-old-man who had a relapse 6 years after diagnosis with the "air crescent" sign on chest CT. Seven years after his diagnosis the patient presented a new relapse with cavitary lung disease, and high levels of anti-proteinase 3 antibodies, suggesting disease activity; however, a transbronchial biopsy showed histological findings of tuberculosis (TB). The association between TB and GPA is rarely informed; moreover TB and GPA have similar findings including both clinical and anti-proteinase 3 antibodies.