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Full-color, coronal 3D VR (volume rendering) with 360 degrees of rotation about the long axis of the trachea, emphasizing central airways. B. Higher magnification without axis. The images demonstrate an irregular, long region of segmental stenosis involving the upper trachea. The patient also presented with multiple pulmonary nodules, at least one of which was cavitary. A diagnosis of granulomatosis with polyangiitis or GPA (previously known as Wegener granulomatosis) was established on tracheal biopsy. Video available on AccessMedicine.com.