内容紹介
Summary
A 76—year—old female was followed up for rheumatoid arthritis—associated interstitial lung disease(RA—ILD). Consolidation and ground—glass opacities were observed in the right lung. When the corticosteroid was restarted due to a relapse of RA—ILD, most of the shadows disappeared. However, ground—glass nodules remained in the apex of the right lung. Thoracoscopic segmentectomy was performed, and lung cancer was diagnosed. Patients with rheumatoid arthritis suffer from complications such as RA—ILD, drug—induced pneumonia, pulmonary infections, and malignancies. A careful assessment of treatment response should be made in case of a differential diagnosis.
要旨
症例は76歳,女性。リウマチ関連間質性肺疾患として経過観察中に右肺に浸潤影とすりガラス陰影が出現した。リウマチ関連間質性肺疾患の再燃としてステロイドを再開したところ陰影の大部分は消退したが,右肺尖部のすりガラス様結節が残存した。胸腔鏡補助下区域切除術を行い,肺癌と診断した。関節リウマチ患者にはリウマチ関連間質性肺疾患,薬剤性肺障害,感染症,悪性腫瘍などが合併し得るが,治療反応性の慎重な見極めは鑑別診断に寄与する。
目次
A 76—year—old female was followed up for rheumatoid arthritis—associated interstitial lung disease(RA—ILD). Consolidation and ground—glass opacities were observed in the right lung. When the corticosteroid was restarted due to a relapse of RA—ILD, most of the shadows disappeared. However, ground—glass nodules remained in the apex of the right lung. Thoracoscopic segmentectomy was performed, and lung cancer was diagnosed. Patients with rheumatoid arthritis suffer from complications such as RA—ILD, drug—induced pneumonia, pulmonary infections, and malignancies. A careful assessment of treatment response should be made in case of a differential diagnosis.
要旨
症例は76歳,女性。リウマチ関連間質性肺疾患として経過観察中に右肺に浸潤影とすりガラス陰影が出現した。リウマチ関連間質性肺疾患の再燃としてステロイドを再開したところ陰影の大部分は消退したが,右肺尖部のすりガラス様結節が残存した。胸腔鏡補助下区域切除術を行い,肺癌と診断した。関節リウマチ患者にはリウマチ関連間質性肺疾患,薬剤性肺障害,感染症,悪性腫瘍などが合併し得るが,治療反応性の慎重な見極めは鑑別診断に寄与する。