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Pulmonary necrobiotic nodules without rheumatoid arthritis
British Journal of Diseases of the Chest
|October 1, 1978
Summary
Pulmonary necrobiotic nodules, rare in rheumatoid arthritis, can appear before systemic disease or rheumatoid factor. Histology confirms diagnosis even without typical rheumatoid arthritis markers.
Area of Science:
- Rheumatology
- Pulmonary Medicine
- Pathology
Background:
- Pulmonary necrobiotic nodules are uncommon manifestations of rheumatoid arthritis.
- Histological features are indistinguishable from subcutaneous rheumatoid nodules.
- Typically, systemic rheumatoid arthritis precedes pulmonary involvement.
Observation:
- This study describes seven cases of pulmonary nodules preceding or occurring without systemic rheumatoid arthritis.
- All cases exhibited typical histological and radiological features of necrobiotic nodules.
- Multiple sites and cavitation were observed in five cases each.
Findings:
- Pulmonary nodules appeared before systemic rheumatoid arthritis in three cases.
- Four cases showed no systemic rheumatoid arthritis development despite follow-up.
- All patients tested negative for rheumatoid factor.
Implications:
- The diagnosis of pulmonary necrobiotic nodules is possible even in the absence of systemic rheumatoid arthritis and rheumatoid factor.
- Histological confirmation is crucial for diagnosis in atypical presentations.
- These findings expand the understanding of rheumatoid arthritis-associated lung disease spectrum.