Article Figures & Data
Figures
- Figure 1.
Chest radiograph showing cavitated nodular lesion in the apical part of the right lung (arrow).
- Figure 2.
Computed tomography of the chest showing a pulmonary nodule in the right lung with cavitation.
- Figure 3.
Chest radiograph and computed tomography showing disseminated bilateral and merging nodules.
Tables
- Table 1.
Case series of pulmonary nodulosis and hilar adenopathies occurring in patients with rheumatoid arthritis under anti-TNF-α treatment.
Case Age, Sex Disease duration, yrs Extraarticular Disease DMARD Anti-TNF-α Agent and Delay (mo) Clinical Symptoms Chest Radiograph and Computed Tomography Biopsy Outcome 1 70 M 10 — LEF IFX (48) — Multiple nodular lesions in the 2 lung bases Rheumatoid nodule IFX maintained No progression of the nodules 2 57 M 7 Subcutaneous nodules LEF ADA (12) Asthenia Cavitated lesion at the apical part of the right lung No ADA discontinued Resolution 3 74 M 8 Subcutaneous nodules MTX IFX (48) — Large nodule in right midzone and disseminated micronodules Rheumatoid nodule IFX discontinued. No progression of the nodules 4 70 F 9 Subcutaneous nodules LEF ETA (9) — Disseminated bilateral nodules Chronic and inflammatory granulomatous lesion ETA discontinued. Resolution with rituximab treatment 5 54 M 2 — MTX ETA (6) Asthenia, cough Large nodule in left lung with disseminated micronodular lesions Granulomatous lesion with central necrosis ETA discontinued. Resolution with rituximab treatment 6 45 F 12 Pulmonary fibrosis — ETA (24) Cough Bilateral merging nodules predominating at the apical part of the 2 lungs Rheumatoid nodules ETA maintained. No progression of nodules 7 56 M 29 Vasculitis — ETA (13) Chest pain Bilateral hilar adenopathies lesion with silica Noncaseating granlomatous particles ETA discontinued. No progression of nodules 8 45 F 4 — LEF ADA (12) Cough, dyspnea Appearance of new nodular lesion in each lung No ADA maintained. No progression of nodules 9 52 M 7 — — ETA (36) — Nodules in apical region of the 2 lungs No ETA maintained. No progression of nodules 10 54 M 8 — MTX ETA (31) — Multiple cavitating nodular lesion in right lung base Granulomatous lesion with central necrosis ETA discontinued. No progression of nodules 11 42 M 6 — LEF ADA (17) — 3 nodules in apical region of right lung RN ADA discontinued and then restarted: development of new nodules -
DMARD: disease-modifying antirheumatic drug; LEF: leflunomide; MTX: methotrexate; IFX: infliximab; ETA: etanercept; ADA: adalimumab; RN: rheumatoid nodule.
-
- Table 2.
Cases of subcutaneous and pulmonary nodulosis in patients receiving anti-TNF-α agents.
Report Location of Nodules Age, Sex Anti-TNF-α and delay Associated Treatment Preexisting Nodules Clinical Symptoms Biopsy Treatment Outcome Mackley2 SC — IFX (1 yr) — No Nodules of hands RN ND ND Cunnane3 SC 52 M ETA (2 mo) CS SC Development of new cutaneous nodules No Maintenance of ETA No progression of nodules SC 50 M (3 mo) CS SC Development of new cutaneous nodules No Maintenance of ETA Resolution of pulmonary Lungs 67 M (2 mo) CS Pulmonary nodule Dyspnea: cavitating pulmonary nodules RN ETA discontinued nodules Scrivo8 SC 45 F ADA (2 yrs) CS No Nodules of elbows No Maintenance of ADA No progression of nodules Kekow9 SC and lungs 53 F ETA (7 mo) CS No Nodules of hands and elbows; nodular lesion on chest radiograph RN ETA discontinued Diminished size of nodules Hübscher10 SC and lung 41 F ETA (yr) LEF + CS SC Development of new cutaneous nodules and appearance of nodular lung lesion RN ETA discontinued ND Van Ede11 Lungs 50 M ETA (2 yrs) LEF SC Nodular lesions on chest radiograph RN ETA discontinued Resolution of cutaneous and pulmonary nodules Watson12 Lungs 57 F ETA (1 yr) LEF + CS No Dry cough No ETA maintained No progression of nodules -
SC: subcutaneous; CS: corticosteroids; LEF: leflunomide; MTX: methotrexate; RN: rheumatoid nodule; ND: not determined.
-
In this issue
Pulmonary Nodulosis and Aseptic Granulomatous Lung Disease Occurring in Patients with Rheumatoid Arthritis Receiving Tumor Necrosis Factor-α-Blocking Agent: A Case Series
