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Published on: June 23, 2014
Lung biopsy in rheumatoid arthritis
The American Review of Respiratory Disease
|May 1, 1985
Summary
Histologic patterns in rheumatoid arthritis lung disease vary widely. Rheumatoid nodules suggest a good prognosis, while usual interstitial pneumonia indicates a poor outcome, highlighting the need for specific diagnoses over the general term "rheumatoid lung disease".
Area of Science:
- Pulmonary Pathology
- Rheumatology
- Histopathology
Background:
- Rheumatoid arthritis (RA) can affect the lungs, a condition sometimes termed "rheumatoid lung disease."
- Histologic patterns of lung involvement in RA are diverse and may influence patient outcomes.
- Correlation between histology, radiology, and physiology in RA lung disease requires clarification.
Purpose of the Study:
- To review lung biopsy findings in rheumatoid arthritis patients.
- To correlate histopathologic patterns with radiologic, physiologic, and prognostic variables.
- To assess the diagnostic utility of the term "rheumatoid lung disease."
Main Methods:
- Retrospective review of 40 open lung biopsies from patients with rheumatoid arthritis.
- Classification of biopsies into distinct histopathologic patterns.
- Analysis of correlations between histological findings and clinical data.
Main Results:
- Five main histologic patterns were identified: rheumatoid nodules, usual interstitial pneumonia (UIP), bronchiolitis obliterans with organizing pneumonia (BOOP), lymphoid hyperplasia, and cellular interstitial infiltrates.
- Rheumatoid nodules showed a uniformly good prognosis.
- UIP indicated a poor prognosis, while BOOP and lymphoid hyperplasia/interstitial infiltrates had more favorable outcomes compared to UIP.
- No consistent correlations were found between pulmonary function tests and radiographic/histologic findings.
Conclusions:
- The term "rheumatoid lung disease" is not a useful histologic diagnosis due to its broad spectrum of changes.
- Specific histopathologic patterns, such as rheumatoid nodules or UIP, are crucial for determining prognosis in RA-associated lung disease.
- Accurate histologic classification is essential for predicting patient outcomes in rheumatoid arthritis lung involvement.
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