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KMID : 0383820110700020150
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Tuberculosis and Respiratory Diseases
2011 Volume.70 No. 2 p.150 ~ p.154
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Caplan’s Syndrome Presenting as Multiple Pulmonary Nodules
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Lee Sang-Kook
Lee Sang-Hoon
Kim Song-Yee
Lee Woo-Kyung
Shin Dong-Ho
Bang Woo-Dae
Noh Song-Mi
Shim Hyo-Sup
Park Byung-Hoon
Lee Kyung-Jong
Park Moo-Suk
Kim Young-Sam
Chang Joon
Kim Se-Kyu
Kang Young-Ae
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Abstract
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We report a case of Caplan’s Syndrome, which presented as multiple pulmonary nodules. A 58-year-old male was admitted to hospital due to multiple pulmonary nodules. In addition, the patient presented with multiple arthritis, and dyspnea on exertion. Rheumatoid arthritis had been diagnosed 35 years ago. The patient had worked as a stonemason for 20 years. Computed Tomography (CT) revealed numerous well-defined tiny nodules scattered in both lungs, which was suspicious of miliary tuberculosis or malignancy. The patient was started on antituberculous medications and referred to our hospital. First, a transbronchial lung biopsy was performed, which showed no evidence of granuloma. It was our opinion that the biopsy was insufficient, and a follow-up video-associated thoracoscopy was performed. The pathological report determined necrotizing granulomatous inflammation and silicosis on background. According to imaging studies, pathologic reports, and clinical symptoms, we concluded that the patient had Caplan’s syndrome. We controlled his rheumatic medications, and instructed him to avoid exposure to hazardous dust.
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KEYWORD
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Caplan Syndrome, Multiple Pulmonary Nodules, Arthritis, Rheumatoid
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