Adelman H M, Dupont E L, Flannery M T, Wallach P M
Department of Internal Medicine, University of South Florida Health Sciences Center, Tampa.
Am J Med Sci. 1994 Sep;308(3):171-2. doi: 10.1097/00000441-199409000-00009.
Rheumatoid arthritis is a multi-system disease. Pulmonary manifestations and complications include pleural disease, pulmonary infections, pneumonitis and interstitial pulmonary fibrosis, bronchogenic carcinoma, arteritis with pulmonary hypertension, obliterative bronchiolitis, bronchiectasis, and amyloidosis. Pulmonary rheumatoid nodules, including rheumatoid pneumoconiosis (Caplan's Syndrome), can result in spontaneous pneumothorax. In this article, the authors present a patient with rheumatoid arthritis and recurrent spontaneous pneumothorax. Through investigation, a bronchopleural fistula caused by a rheumatoid nodule was revealed. The authors also discuss the potential pitfalls caused by a lung nodule in a patient with rheumatoid arthritis, including the overlap with bronchogenic carcinoma and confusion with tuberculosis.
类风湿关节炎是一种多系统疾病。肺部表现和并发症包括胸膜疾病、肺部感染、肺炎和间质性肺纤维化、支气管源性癌、伴有肺动脉高压的动脉炎、闭塞性细支气管炎、支气管扩张和淀粉样变性。肺类风湿结节，包括类风湿尘肺（卡普兰综合征），可导致自发性气胸。在本文中，作者介绍了一名患有类风湿关节炎和复发性自发性气胸的患者。通过调查，发现了一个由类风湿结节引起的支气管胸膜瘘。作者还讨论了类风湿关节炎患者肺部结节可能导致的潜在陷阱，包括与支气管源性癌的重叠以及与肺结核的混淆。
