CTICasesRheumatoid Lung Nodules
Imaging findings
Serial chest CT scans obtained two years apart in a 75-year-old woman with rheumatoid arthritis demonstrate multiple slowly progressive, well-circumscribed, and peripheral subpleural nodules in both lungs. Several of the nodules, including one located adjacent to the right lower lobe spine, develop central cavitation over time, without secondary signs of infection or malignancy.
Key takeaways
Rheumatoid nodules (necrobiotic nodules) are a classic pulmonary manifestation of rheumatoid arthritis. They are typically asymptomatic, multiple, and located in a subpleural or peripheral distribution, frequently in the upper lobes. They can cavitate, wax and wane, or slowly enlarge over years, mimicking metastatic disease or fungal infections, and biopsy is diagnostic showing necrobiotic granulomas.
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