Difficulties in the differential diagnosis of focal lung lesions in a patient with rheumatoid arthritis who has received anti-B-cell therapy with rituximab. Description of a clinical case
https://doi.org/10.14412/1996-7012-2024-1-76-83
Abstract
We present a clinical case of a patient treated with rituximab and methotrexate for rheumatoid arthritis with progressive focal lung lesions that were difficult to interpret. The complexity of the problem of focal lung lesions in rheumatic diseases, which involves a broad spectrum of clinical medical disciplines, is emphasized.
About the Authors
M. D. Suprun
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
34A, Kashirskoe shosse, Moscow 115522
P. A. Sholkina
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
34A, Kashirskoe shosse, Moscow 115522
L. A. Semyonova
V.A. Nasonova Research Institute of Rheumatology;
Central Research Institute of Tuberculosis
Russian Federation
Russian Federation
34A, Kashirskoe shosse, Moscow 115522;
2, Yauzskaya Alley, Build. 1A, Moscow 107564
L. P. Ananyeva
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
34A, Kashirskoe shosse, Moscow 115522
References
1. Gould MK, Donington J, Lynch WR, et al. Evaluation of individuals with pulmonary nodules: when is it lung cancer? Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013 May; 143(5 Suppl):e93S-e120S. doi: 10.1378/chest.12-2351.
2. Furman AM, Dit Yafawi JZ, Soubani AO. An update on the evaluation and management of small pulmonary nodules. Future Oncol. 2013 Jun;9(6):855-65. doi: 10.2217/fon.13.17.
3. Puzik VP, Uvarova OA, Averbakh MM Patomorfologiya sovremennykh form legochnogo tuberkuleza [Pathomorphology of modern forms of pulmonary tuberculosis]. Moscow: Meditsina; 1973. 216 p.
4. Porhanov VA, Shulzhenko LV, Polyakov IS, et al. Diagnosis of solitary pulmonary nodules and patients follow-up strategy. Kazanskii meditsinskii zhurnal. 2016;(5):736-743. (In Russ.).
5. Ray JF 3rd, Lawton BR, Magnin GE, et al. The coin lesion story: update 1976. Twenty years' experience with thoracotomy for 179 suspected malignant coin lesions. Chest. 1976 Sep;70(03):332-6. doi: 10.1378/chest.70.3.332.
6. Wahidi MM, Govert JA, Goudar RK, et al; American College of Chest Physicians. Evidence for the treatment of patients with pulmonary nodules: when is it lung cancer?: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007 Sep; 132(3 Suppl):94S-107S. doi: 10.1378/chest.07-1352.
7. Siegelman SS, Khouri NF, Scott WW Jr, et al. Pulmonary hamartoma: CT findings. Radiology. 1986 Aug;160(2):313-7. doi: 10.1148/radiology.160.2.3726106.
8. Gribetz AR, Damsker B, Bottone EJ, et al. Solitary pulmonary nodules due to nontuberculous mycobacterial infection. Am J Med. 1981 Jan;70(1):39-43. doi: 10.1016/0002-9343(81)90409-5.
9. Satybaldyev AM, Ananyeva LP. Rheumatoid nodules in the lung parenchyma in rheumatoid arthritis. Nauchno-prakticheskaya revmatologiya. 2019;57(3):349-355. (In Russ.).
10. Conway R, Low C, Coughlan RJ, et al. Methotrexate and lung disease in rheumatoid arthritis: a meta-analysis of randomized controlled trials. Arthritis Rheumatol. 2014 Apr; 66(4):803-12. doi: 10.1002/art.38322.
11. Chansakul T, Dellaripa PF, Doyle TJ, Madan R. Intra-thoracic rheumatoid arthritis: Imaging spectrum of typical findings and treatment related complications. Eur J Radiol. 2015 Oct;84(10):1981-91. doi: 10.1016/j.ejrad.2015.07.008.
12. Balbir-Gurman A, Guralnik L, Best LA, et al. Accelerated pulmonary nodulosis and sterile pleural effusion in a patient with psoriatic arthropathy during methotrexate therapy: a case report. J Clin Rheumatol. 2009 Feb; 15(1):29-30. doi: 10.1097/RHU.0b013e 31817de10b.
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For citations:
Suprun MD, Sholkina PA, Semyonova LA, Ananyeva LP. Difficulties in the differential diagnosis of focal lung lesions in a patient with rheumatoid arthritis who has received anti-B-cell therapy with rituximab. Description of a clinical case. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2024;18(1):76-83. https://doi.org/10.14412/1996-7012-2024-1-76-83
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