Interstitial lung diseases

Rheumatoid lung disease

Last author update: 1 December 2011
Last staff update: 9 June 2023

Copyright: 2003-2023,, Inc.

PubMed search: rheumatoid lung disease [title]

Elliot Weisenberg, M.D.
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Cite this page: Weisenberg E. Rheumatoid lung disease. website. Accessed September 21st, 2023.
Definition / general
  • Variable presentation of chronic pleuritis, effusion, diffuse interstitial fibrosis, intrapulmonary rheumatoid nodules, rheumatoid nodules with pneumoconiosis (Caplan 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
  • Steroids (thus, must first rule out an infectious process)
Gross description
  • Pleural fibrosis, rheumatoid nodules and pneumonia
Microscopic (histologic) description
  • 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 Caplan syndrome
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