Lung - nontumor
Other nonneoplastic disease
Rheumatoid lung disease

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 23 March 2017, last major update December 2011

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed search: rheumatoid lung disease [title]

Cite this page: Rheumatoid lung disease. PathologyOutlines.com website. http://pathologyoutlines.com/topic/lungnontumorrheumatoid.html. Accessed August 20th, 2017.
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
Treatment
  • Steroids (thus, must first rule out an infectious process)
Gross description
  • Pleural fibrosis, rheumatoid nodules and pneumonia
Gross images

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Rheumatoid nodules

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
Microscopic (histologic) images

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Nodules with central necrosis and pallisading histiocytes

Vasculitis

Differential diagnosis