A single pulmonary rheumatoid nodule masquerading as malignancy
| Autor: | A. Zioga, Paraskevi V. Voulgari, Z. M. Metafratzi, Alexandros A. Drosos, N. C. Acritidis, Niki Tsifetaki |
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| Rok vydání: | 2005 |
| Předmět: |
Male
Pathology medicine.medical_specialty Lung Neoplasms Rheumatoid nodule Malignancy Rheumatoid Nodule/diagnosis/pathology Diagnosis Differential Rheumatology Biopsy Humans Rheumatoid factor Medicine Lung Neoplasms/diagnosis/pathology Solitary pulmonary nodule medicine.diagnostic_test business.industry Decision Trees Solitary Pulmonary Nodule General Medicine Middle Aged medicine.disease Solitary Pulmonary Nodule/diagnosis/pathology Subcutaneous nodule Rheumatoid arthritis Radiology Differential diagnosis medicine.symptom Rheumatoid Nodule business |
| Zdroj: | Clinical Rheumatology. 24:556-559 |
| ISSN: | 1434-9949 0770-3198 |
| DOI: | 10.1007/s10067-005-1091-z |
| Popis: | We present a 54-year-old man, a heavy smoker, with clinical and laboratory evidence of familial hypercholesterolemia and an asymptomatic solitary pulmonary nodule (SPN) increasing in size on follow-up chest X-ray. Laboratory work-up revealed high titers of rheumatoid factor and the presence of acute phase reactants. Because of the patient's age and history of smoking, open lung biopsy was performed to rule out malignancy. The biopsy showed histological features compatible with a rheumatoid nodule. Identical features were noted in the histological examination of the subcutaneous nodule. Usually, rheumatoid nodules occur in patients with active, long-standing rheumatoid arthritis (RA) with other extra-articular manifestations. The presence of a single pulmonary rheumatoid nodule as the first manifestation of RA is extremely rare. Histologic proof is often required since pulmonary carcinoma can present an identical clinical and radiological pattern. The diagnostic work-up and the differential diagnosis of an SPN, particularly in a heavy smoker, is a common clinical request and remains a diagnostic challenge. Clin Rheumatol |
| Databáze: | OpenAIRE |
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