title: Lung biopsy in rheumatoid arthritis.
abstract: Forty open lung biopsies from patients with rheumatoid arthritis and possible "rheumatoid lung disease" were reviewed in an attempt to correlate histology with radiologic, physiologic, and prognostic variables. A wide variety of histopathologic features was seen, and primary and secondary patterns of injury were recognized. Five different groups based on histologic patterns were identified: pulmonary rheumatoid nodules, usual interstitial pneumonia (UIP), bronchiolitis obliterans with patchy organizing pneumonia (BOOP), lymphoid hyperplasia, and cellular interstitial infiltrates. The finding of rheumatoid nodules as the primary pattern imparted a uniformly good prognosis, whereas the pattern of UIP indicated a poor one. Patients with BOOP had a more favorable prognosis than did patients with UIP, as did patients with lymphoid hyperplasia and/or nonspecific cellular interstitial infiltrates. Consistent correlations between pulmonary function testing and roentgenographic and histologic findings were not found. The term "rheumatoid lung disease" is of no use as a histologic diagnosis because it encompasses a broad spectrum of morphologic changes that carry significantly different prognoses.
mesh_terms: D000974:Antibodies, Antinuclear / Q000032:analysis; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000473:pathology*; D001706:Biopsy; D005260:Female; D006046:Gold / Q000627:therapeutic use; D006801:Humans; D008168:Lung / Q000473:pathology* / Q000503:physiopathology; D008171:Lung Diseases / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010396:Penicillamine / Q000627:therapeutic use; D011379:Prognosis; D013902:Radiography, Thoracic; D012129:Respiratory Function Tests; D012217:Rheumatoid Factor / Q000032:analysis; D012218:Rheumatoid Nodule / Q000473:pathology
chemical_list: D000974:Antibodies, Antinuclear; D006046:Gold; D012217:Rheumatoid Factor; D010396:Penicillamine