A rheumatoid nodule in an unusual location: mediastinal lymph node
- 1Department of Rheumatology, Cooper Medical School of Rowan University, Camden, New Jersey, USA
- 2Department of Internal Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, USA
- 3Department of Pulmonary, Marshfield Clinic, Marshfield, Wisconsin, USA
- Correspondence to Dr Ralph Yachoui,
Rheumatoid arthritis (RA) is a multisystem inflammatory disease characterised by destructive synovitis and varied extra-articular involvement. Rheumatoid lung nodules are the most common pulmonary manifestations of RA. Rheumatoid nodules in mediastinal lymph nodes are extremely uncommon. We describe a male patient with long-standing RA and subcutaneous rheumatoid nodules presenting with multiple lung nodules and mediastinal lymphadenopathies. Definite histopathology of a lymph node was consistent with necrobiotic granuloma due to RA. Clinicians should be aware of rheumatoid nodules as a potential cause of mediastinal lymphadenopathies, mainly in advanced rheumatoid arthritis.