Table 1.

Case series of pulmonary nodulosis and hilar adenopathies occurring in patients with rheumatoid arthritis under anti-TNF-α treatment.

CaseAge, SexDisease duration, yrsExtraarticular DiseaseDMARDAnti-TNF-α Agent and Delay (mo)Clinical SymptomsChest Radiograph and Computed TomographyBiopsyOutcome
170 M10LEFIFX (48)Multiple nodular lesions in the 2 lung basesRheumatoid noduleIFX maintained No progression of the nodules
257 M7Subcutaneous nodulesLEFADA (12)AstheniaCavitated lesion at the apical part of the right lungNoADA discontinued Resolution
374 M8Subcutaneous nodulesMTXIFX (48)Large nodule in right midzone and disseminated micronodulesRheumatoid noduleIFX discontinued. No progression of the nodules
470 F9Subcutaneous nodulesLEFETA (9)Disseminated bilateral nodulesChronic and inflammatory granulomatous lesionETA discontinued. Resolution with rituximab treatment
554 M2MTXETA (6)Asthenia, coughLarge nodule in left lung with disseminated micronodular lesionsGranulomatous lesion with central necrosisETA discontinued. Resolution with rituximab treatment
645 F12Pulmonary fibrosisETA (24)CoughBilateral merging nodules predominating at the apical part of the 2 lungsRheumatoid nodulesETA maintained. No progression of nodules
756 M29VasculitisETA (13)Chest painBilateral hilar adenopathies lesion with silicaNoncaseating granlomatous particlesETA discontinued. No progression of nodules
845 F4LEFADA (12)Cough, dyspneaAppearance of new nodular lesion in each lungNoADA maintained. No progression of nodules
952 M7ETA (36)Nodules in apical region of the 2 lungsNoETA maintained. No progression of nodules
1054 M8MTXETA (31)Multiple cavitating nodular lesion in right lung baseGranulomatous lesion with central necrosisETA discontinued. No progression of nodules
1142 M6LEFADA (17)3 nodules in apical region of right lungRNADA 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.