Teruuchi S, Bando M, Sugiyama Y, Kitamura S, Murayama H, Sohara Y, Hironaka M, Kuriki K, Saito K
Department of Pulmonary Medicine, Jichi Medical School, Tochigi, Japan.
Nihon Kokyuki Gakkai Zasshi. 1999 Oct;37(10):829-33.
A 66-year-old woman who had been treated at a nearby hospital since 1977 for rheumatoid arthritis complained of cough. Chest X-ray films disclosed multiple nodular shadows with cavitation in the fields of both lungs. The patient was admitted to our hospital and a thoracoscopic lung biopsy was performed. Histologically, the nodule consisted of necrotizing granuloma, indicating a necrobiotic nodule. Rheumatoid nodule was diagnosed because the patient exhibited rheumatoid arthritis. The chest X-ray shadow disappeared without medication. Rheumatoid nodules without coniosis are uncommon, but should be considered in the differential diagnosis of lung nodular lesions in patients with rheumatoid arthritis.
一名自1977年起在附近医院接受类风湿关节炎治疗的66岁女性主诉咳嗽。胸部X光片显示双肺野有多个伴有空洞的结节状阴影。该患者被收入我院并接受了胸腔镜肺活检。组织学检查显示，结节由坏死性肉芽肿组成，提示为坏死性结节。由于患者患有类风湿关节炎，故诊断为类风湿结节。胸部X光阴影未用药即消失。无尘肺的类风湿结节并不常见，但在类风湿关节炎患者肺部结节性病变的鉴别诊断中应予以考虑。
