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Published on: June 16, 2018
Cavitary lung nodules as an extraintestinal manifestation of ulcerative colitis
Nicole Paul1, Mark Lazarev2, Kristina Montemayor3
1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA npaul11@jh.edu.
Abstract:
A man in his 30s with ulcerative colitis (UC) on immunosuppressive agents and extensive travel history presented with subacute dyspnoea and dry cough. CT of the chest demonstrated numerous cavitary pulmonary nodules. An extensive infectious, malignant and autoimmune evaluation was pursued, ultimately with histopathology most consistent with necrobiotic lung nodules as an extraintestinal manifestation of UC. Steroids and ustekinumab were initiated with improvement in symptoms and resolution of cavitary lesions on follow-up imaging. In a patient with inflammatory bowel disease and cavitary lung lesions, necrobiotic lung nodules should be considered, particularly when evaluation for infectious causes is negative.
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