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Lung-nontumor

Other non-neoplastic disease

Rheumatoid lung disease


Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 19 December 2011, last major update December 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

General
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● Variable presentation of chronic pleuritis, effusion, diffuse interstitial fibrosis, intrapulmonary rheumatoid nodules, rheumatoid nodules with pneumoconiosis (Caplanís syndrome), pulmonary hypertension, bronchiolitis obliterans, amyloidosis and vasculitis
● Note: 30% with rheumatoid arthritis have abnormal pulmonary function
● Rheumatoid nodules are associated with active joint disease and elevated titers of rheumatoid factor

Treatment
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● Steroids (thus, must first rule out an infectious process)

Gross description
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● Pleural fibrosis, rheumatoid nodules and pneumonia

Gross images
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Rheumatoid nodules

Micro description
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● Rheumatoid granuloma usually in lung periphery near pleura
● Round with zone of pallisading histiocytes perpendicular to necrobiotic center
● Adjacent vasculitis
● Nodules have carbon and silica within the necrotic center in Caplanís syndrome

Micro images
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Nodules with central necrosis and pallisading histiocytes

   
Vasculitis

Differential diagnosis
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● Wegenerís granulomatosis

End of Lung-nontumor > Other non-neoplastic disease > Rheumatoid lung disease


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