Rheumatoid lung nodule
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Rheumatoid lung nodule, also rheumatoid nodule of the lung and pulmonary rheumatoid nodule, is an uncommon benign lung lesion associated with rheumatoid arthritis.
| Rheumatoid lung nodule | |
|---|---|
| Diagnosis in short | |
|
| |
| LM | mixed inflammatory infiltrate, +/-giant cells, no micro-organisms |
| LM DDx | necrotic pulmonary nodules in Crohn's disease, infectious pneumonia, amyloidosis of lung |
| Stains | ZN -ve, GMS -ve |
| Site | lung - see medical lung diseases |
|
| |
| Associated Dx | rheumatoid arthritis |
| Clinical history | +/-hx of rheumatoid arthritis |
| Prevalence | uncommon |
| Radiology | upper lung fields, peripheral, round, +/-cavitation |
| Clin. DDx | only lung lesions - esp. malignancy |
Rheumatoid lung disease redirects here. Rheumatoid pleuritis is dealt with separately.
General
- Rare.[1]
Common associations:[1]
- Male.
- RF +ve.
- Skin nodules - see rheumatoid nodule.
Gross/radiology
Features:[1]
- Usually upper lung fields, peripheral and round.
- +/-Cavitation (~50% of cases).
Microscopic
Features:[2]
- Mixed inflammatory infiltrate.
- +/-Giant cells.
- No micro-organisms.
Dx:
- Necrotic pulmonary nodule in Crohn's disease.
- Infectious pneumonia.
- Amyloidosis[3] - reported in the context with rheumatoid arthritis.[4]
Images
www:
Stains
- ZN stain -ve for AFB.
- GMS stain -ve for fungal organisms.
- Congo red -ve.
See also
References
- ↑ 1.0 1.1 1.2 Gómez Herrero, H.; Arraiza Sarasa, M.; Rubio Marco, I.; García de Eulate Martín-Moro, I.. "Pulmonary rheumatoid nodules: presentation, methods, diagnosis and progression in reference to 5 cases.". Reumatol Clin 8 (4): 212-5. doi:10.1016/j.reuma.2011.09.004. PMID 22265461.
- ↑ 2.0 2.1 2.2 Chhakchhuak, CL.; Khosravi, M.; Lohr, KM. (2013). "Role of (18)F-FDG PET Scan in Rheumatoid Lung Nodule: Case Report and Review of the Literature.". Case Rep Rheumatol 2013: 621340. doi:10.1155/2013/621340. PMID 23984160.
- ↑ Tokunaga T, Takeda S, Sawabata N, Inoue M, Maeda H (September 2006). "Nodular pulmonary amyloidosis". Jpn J Thorac Cardiovasc Surg 54 (9): 399–401. doi:10.1007/s11748-006-0015-4. PMID 17037396.
- ↑ Calatayud J, Candelas G, Gómez A, Morado C, Trancho FH (October 2007). "Nodular pulmonary amyloidosis in a patient with rheumatoid arthritis". Clin Rheumatol 26 (10): 1797–8. doi:10.1007/s10067-007-0552-y. PMID 17332981.