Walters M N, Ojeda V J
Med J Aust. 1986 Jun 9;144(12):648-51.
Pleuropulmonary rheumatoid nodules were diagnosed histologically in six patients of whom five were known to have rheumatoid arthritis; the pulmonary lesion preceded the development of arthritis in the sixth patient. Pulmonary lesions are commonly found in patients with rheumatoid arthritis. These lesions are either non-specific (effusions, pleurisy, fibrosis, arteritis and obliterative bronchiolitis) or the specific necrobiotic nodules that constitute Caplan's syndrome in association with pneumoconiosis. The necrobiotic nodules are usually pleural or subpleural and rarely occur in the bronchial tree. Pulmonary necrobiotic nodules can appear before, coincident with, or after the onset of arthritis. It is essential to distinguish these lesions from infections or neoplasia.
经组织学诊断，6例患者患有胸膜肺类风湿结节，其中5例已知患有类风湿关节炎；第6例患者肺部病变先于关节炎出现。肺部病变在类风湿关节炎患者中很常见。这些病变要么是非特异性的（积液、胸膜炎、纤维化、动脉炎和闭塞性细支气管炎），要么是与尘肺相关的构成卡普兰综合征的特异性坏死结节。坏死结节通常位于胸膜或胸膜下，很少出现在支气管树中。肺部坏死结节可在关节炎发作之前、同时或之后出现。将这些病变与感染或肿瘤区分开来至关重要。
