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Computed tomography findings of Caplan syndrome
Hiroaki Arakawa1, Koichi Honma, Hisao Shida
1Department of Radiology, Dokkyo University School of Medicine, Mibu, Tochigi, Japan. arakawa@dokkyomed.ac.jp
Journal of Computer Assisted Tomography
|September 23, 2003
Summary
This study details an 18-year follow-up of Caplan syndrome complicated by tuberculosis. Autopsy revealed rheumatoid nodules mimicking silicotic nodules, highlighting diagnostic challenges in pneumoconiosis.
Area of Science:
- Rheumatology
- Pulmonary Medicine
- Pathology
Background:
- Caplan syndrome, a condition affecting rheumatoid arthritis patients exposed to silica dust, presents diagnostic challenges.
- Co-occurrence of Caplan syndrome with tuberculosis is rare and complicates clinical presentation.
Observation:
- A case of Caplan syndrome with concurrent tuberculosis was followed for 18 years.
- Initial imaging revealed large nodules alongside pneumoconiotic changes; one nodule cavitated over time.
- Computed tomography (CT) identified calcification in one large nodule.
Findings:
- Autopsy confirmed two large nodules as burned-out rheumatoid nodules.
- Additional rheumatoid nodules were found, morphologically indistinguishable from silicotic nodules on CT.
- The coexistence of tuberculosis and Caplan syndrome posed diagnostic difficulties.
Implications:
- This case underscores the importance of considering rheumatoid nodules in the differential diagnosis of lung nodules in Caplan syndrome patients.
- Advanced imaging and autopsy are crucial for accurate diagnosis in complex cases.
- Understanding the imaging characteristics of rheumatoid nodules is vital for differentiating them from other lung pathologies.