Yachoui Ralph, Ward Celine, Kreidy Mazen
Department of Rheumatology, Cooper Medical School of Rowan University, Camden, New Jersey, USA.
BMJ Case Rep. 2013 May 2;2013:bcr2013009516. doi: 10.1136/bcr-2013-009516.
Rheumatoid arthritis (RA) is a multisystem inflammatory disease characterised by destructive synovitis and varied extra-articular involvement. Rheumatoid lung nodules are the most common pulmonary manifestations of RA. Rheumatoid nodules in mediastinal lymph nodes are extremely uncommon. We describe a male patient with long-standing RA and subcutaneous rheumatoid nodules presenting with multiple lung nodules and mediastinal lymphadenopathies. Definite histopathology of a lymph node was consistent with necrobiotic granuloma due to RA. Clinicians should be aware of rheumatoid nodules as a potential cause of mediastinal lymphadenopathies, mainly in advanced rheumatoid arthritis.
类风湿关节炎（RA）是一种多系统炎症性疾病，其特征为破坏性滑膜炎和多种关节外表现。类风湿肺结节是RA最常见的肺部表现。纵隔淋巴结中的类风湿结节极为罕见。我们描述了一名患有长期RA和皮下类风湿结节的男性患者，该患者出现多个肺结节和纵隔淋巴结肿大。淋巴结的明确组织病理学检查结果与RA所致的坏死性肉芽肿一致。临床医生应意识到类风湿结节是纵隔淋巴结肿大的一个潜在原因，主要见于晚期类风湿关节炎患者。
