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Case Reports
. 2013 May 2:2013:bcr2013009516.
doi: 10.1136/bcr-2013-009516.

A rheumatoid nodule in an unusual location: mediastinal lymph node

Ralph Yachoui  1 , Celine Ward, Mazen Kreidy
Affiliations
Case Reports

A rheumatoid nodule in an unusual location: mediastinal lymph node

Ralph Yachoui et al. BMJ Case Rep. .

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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Figures

Figure 1
Figure 1
Subcarinal adenopathy on CT scan.
Figure 2
Figure 2
CT of the chest showing a lung nodule in the left lower lobe, cavitary and immediately subpleural.
Figure 3
Figure 3
Photomicrograph showing a necrobiotic granuloma.
See this image and copyright information in PMC

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