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[Rheumatoid nodule diagnosed by thoracoscopy using flexible fiberoptic bronchoscope].

Abstract
A 51-year-old man had been treated at a nearby hospital since 1993 for rheumatoid arthritis. Right pectoralgia developed in December 1994, and the patient consulted a nearby hospital, which detected right pleural effusion retention was pointed out on chest x-ray films. The patient was referred and admitted to our hospital. Rheumatic pleurisy was suspected because of a high serum rheumatoid factor(RF)level and high RF and high rheumatoid arthritis hemagglutination levels in the pleural effusion. However, due to a high adenosine deaminase level in the pleural effusion tuberculous pleurisy could not be ruled out. After drainage through a trocar catheter, the thoracic cavity was examined by thoracoscopy through the site of catheter insertion. As a result, sporadic bluish white nodular lesions were observed on the pleura. Granuloma formations presenting a palisade arrangement of giant cells were also observed, and pathologically diagnosed as rheumatoid nodules, thus providing the basis for a diagnosis of rheumatic pleurisy. Treatment with an increased dose of prednisolone achieved a rapid remission of the pleural effusion. Our experience underscored the usefulness of thoracoscopy as a means diagnosing of rheumatic pleurisy.
AuthorsK Kimura, K Toyama, M Yoshida, T Hojyo, H Ryo, M Nakata, J Sim
JournalNihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society (Nihon Kokyuki Gakkai Zasshi) Vol. 36 Issue 11 Pg. 994-7 (Nov 1998) ISSN: 1343-3490 [Print] Japan
PMID9916487 (Publication Type: Case Reports, English Abstract, Journal Article)
Chemical References
  • Anti-Inflammatory Agents
  • Prednisolone
Topics
  • Anti-Inflammatory Agents (administration & dosage)
  • Arthritis, Rheumatoid (complications)
  • Biopsy (methods)
  • Bronchoscopy
  • Fiber Optic Technology
  • Humans
  • Male
  • Middle Aged
  • Pleura (pathology)
  • Pleurisy (diagnosis, drug therapy)
  • Prednisolone (administration & dosage)

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