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Canadian Respiratory Journal
Volume 21, Issue 3, Pages e52-e54
http://dx.doi.org/10.1155/2014/593430
Clinico-Pathologic Conferences

What to Do with All of These Lung Nodules?

Dmitry Rozenberg1,2 and Shane Shapera1,2

1Division of Respiratory Medicine, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada
2Department of Medicine, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada

Copyright © 2014 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Caplan syndrome is a rare entity that is specific to rheumatoid arthritis and presents with multiple, well-defined necrotic nodules in patients with occupational dust exposure. The present report describes a case of Caplan syndrome involving a 71-year-old man with a known diagnosis of seropositive rheumatoid arthritis who presented to the authors’ centre with a five-year history of multiple, bilateral cavitary lung nodules with mild dyspnea on exertion. He was an ex-smoker (30 pack-years) and had previously worked with silica. The case highlights the clinical, radiological and pathological features of this syndrome and outlines the importance of considering a broad differential in the management of pulmonary nodules, especially in patients with rheumatoid arthritis.