CTICasesRheumatoid Arthritis with Necrobiotic Nodules complicated by Hydro/Pyopneumothorax and Bronchopleural Fistula
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Imaging findings
Initially, cavitary lesions, some subpleural, with bilateral pleural effusions and collapse of the left lower lobe. On follow-up, progression with larger, more cavitary lesions, thick-walled cavities, hydro/pyopneumothorax, and suspected bronchopleural fistula.
Key takeaways
Rheumatoid necrobiotic nodules can cavitate, progress, and lead to complications like bronchopleural fistulas and empyemas. Amyloid nodules are a differential but were negative on biopsy. Extensive workup for infection was negative.
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