title: [A case of rheumatoid arthritis with pneumothorax due to subpleural pulmonary rheumatoid nodules].
abstract: Pneumothorax secondary to nodular rheumatoid lung disease is a rare complication of rheumatoid arthritis. Here we report a case of rheumatoid arthritis with pneumothorax due to subpleural pulmonary rheumatoid nodule. A 74-year-old woman with a 14-year history of rheumatoid arthritis has admitted to our hospital due to dyspnea and right chest discomfort, and her chest X-ray film and computed tomography revealed right pneumothorax. Her chest X-ray and computed tomography findings before the onset of pneumothorax had demonstrated multiple subpleural cavitary nodules in both lungs. She had taken antifungal agents under a diagnosis of pulmonary fungal infection for a year without any change of her chest radiological findings. After incomplete reexpansion with sustained air leakage by right chest tube drainage, video-assisted thoracic surgery was performed. The pulmonary cavitary nodules of her right middle and lower lobes were with successfully excised. The histopathology of excised subpleural lung nodules showed typical features of rheumatoid nodules, and the cavitation of the rheumatoid nodule in right S5 had fistula formation to the pleural space, and thus was thought to have caused the pneumothorax.
authors.forename: Chinatsu
authors.initials: C
authors.lastname: Nishida
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yatera
authors.forename: Masamizu
authors.initials: M
authors.lastname: Kunimoto
authors.forename: Kei
authors.initials: K
authors.lastname: Yamasaki
authors.forename: Fumiyoshi
authors.initials: F
authors.lastname: Yoda
authors.forename: Toshinori
authors.initials: T
authors.lastname: Kawanami
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Sakurai
authors.forename: Takehiro
authors.initials: T
authors.lastname: Nakamura
authors.forename: Chiharu
authors.initials: C
authors.lastname: Yoshii
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Kido
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000150:complications*; D011030:Pneumothorax / Q000209:etiology*; D012218:Rheumatoid Nodule / Q000150:complications*