A Rheumatoid Nodule in an Unusual Location: Mediastinal Lymph Node

Overview

Journal BMJ Case Rep

Specialty General Medicine

Date 2013 May 7

PMID 23645652

Citations 2

Authors

Ralph Yachoui

Celine Ward

Mazen Kreidy

Affiliations

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Abstract

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.

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References

Nannini C, Ryu J, Matteson E . Lung disease in rheumatoid arthritis. Curr Opin Rheumatol. 2008; 20(3):340-6. DOI: 10.1097/BOR.0b013e3282f798ed. View

Perez T, Dansin E, Wallaert B, Tonnel A . [Pleuro-pulmonary manifestations of rheumatoid polyarthritis]. Rev Mal Respir. 1991; 8(2):169-89. View

Patel R, Naik S, Amchentsev A, Saleh A . A rare cause of multiple cavitary nodules. Chest. 2009; 136(1):306-309. DOI: 10.1378/chest.08-2354. View

Antin-Ozerkis D, Evans J, Rubinowitz A, Homer R, Matthay R . Pulmonary manifestations of rheumatoid arthritis. Clin Chest Med. 2010; 31(3):451-78. DOI: 10.1016/j.ccm.2010.04.003. View

Jolles H, Moseley P, Peterson M . Nodular pulmonary opacities in patients with rheumatoid arthritis. A diagnostic dilemma. Chest. 1989; 96(5):1022-5. DOI: 10.1378/chest.96.5.1022. View

Gordonson J, Quinn M, Kaufman R, van den Tweel J . Mediastinal lymphadenopathy and undifferentiated connective tissue disease: case report and review. AJR Am J Roentgenol. 1978; 131(2):325-8. DOI: 10.2214/ajr.131.2.325. View

Turesson C . Extra-articular rheumatoid arthritis. Curr Opin Rheumatol. 2013; 25(3):360-6. DOI: 10.1097/BOR.0b013e32835f693f. View

Magro C, Crowson A, Regauer S . Granuloma annulare and necrobiosis lipoidica tissue reactions as a manifestation of systemic disease. Hum Pathol. 1996; 27(1):50-6. DOI: 10.1016/s0046-8177(96)90137-9. View

Orme M, MacGilchrist K, Mitchell S, Spurden D, Bird A . Systematic review and network meta-analysis of combination and monotherapy treatments in disease-modifying antirheumatic drug-experienced patients with rheumatoid arthritis: analysis of American College of Rheumatology criteria scores 20, 50, and 70. Biologics. 2012; 6:429-64. PMC: 3529627. DOI: 10.2147/BTT.S36707. View

10.

Nakajima T, Yasufuku K, Yoshino I . Current status and perspective of EBUS-TBNA. Gen Thorac Cardiovasc Surg. 2013; 61(7):390-6. DOI: 10.1007/s11748-013-0224-6. View

11.

Gal A, Koss M . The pathology of sarcoidosis. Curr Opin Pulm Med. 2002; 8(5):445-51. DOI: 10.1097/00063198-200209000-00018. View

12.

Karadag F, Polatli M, Senturk T, Kacar F, Sen S, Cildag O . Cavitary necrobiotic nodule imitating malignant lung disease in a patient without articular manifestations of rheumatoid arthritis. J Clin Rheumatol. 2006; 9(4):246-52. DOI: 10.1097/01.rhu.0000081260.50171.bf. View

13.

Schneider F, Gruden J, Tazelaar H, Leslie K . Pleuropulmonary pathology in patients with rheumatic disease. Arch Pathol Lab Med. 2012; 136(10):1242-52. DOI: 10.5858/arpa.2012-0248-SA. View