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Eur Respir J 2006; 28:872-874
Copyright ©ERS Journals Ltd 2006

Massive cavitary pulmonary rheumatoid nodules in a patient with HIV

N. Khazeni1, R. J. Homer2, A. N. Rubinowitz3 and G. L. Chupp1

Depts of 1 Internal Medicine, Section of Pulmonary and Critical Care Medicine, 2 Pathology, and 3 Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA.

CORRESPONDENCE: G. L. Chupp, Pulmonary and Critical Care Medicine, Yale University School of Medicine, 300 Cedar Street, TAC-441S, PO Box 208057, New Haven, CT 06520, USA. Fax: 1 2037853826. E-mail: geoffrey.chupp{at}yale.edu

Keywords: Cavitary pulmonary nodules, HIV, rheumatoid arthritis

Received: December 7, 2005
Accepted April 6, 2006

The case of a 52-yr-old female with rheumatoid arthritis and HIV who developed massive, progressive, cavitary pulmonary nodules is described.

Multiple diagnostic bronchoscopies and lung biopsies failed to demonstrate the presence of any microorganisms. Pathological analysis showed palisading histiocytes with necrobiosis consistent with rheumatoid nodules.

The effect of co-existing HIV infection on the course and prognosis of rheumatoid arthritis is discussed, and it is concluded that the complex relationship between these two disease processes warrants further investigation.




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