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Liver rheumatoid nodules imitating liver malignancy: a rare occurrence
  1. Jason Wee1,
  2. Salar Sobhi1,
  3. Bastiaan De Boer1,2 and
  4. Dan Xu3,4
  1. 1Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, Australia
  2. 2Anatomical Pathology, PathWest Laboratory Medical WA, Murdoch, Western Australia, Australia
  3. 3School of Public Health, Curtin University Bentley Campus, Perth, Western Australia, Australia
  4. 4Medical Education, Sun Yan-sen University of Medical Sciences, Guangzhou, China
  1. Correspondence to Professor Dan Xu; daniel.xu{at}curtin.edu.au

Abstract

We describe a case of a 61-year-old man with a background of rheumatoid arthritis who presented to the emergency department with a single-reported episode of haemoptysis on the background of an upper respiratory tract infection. A CT scan revealed an incidental 40 mm mass in upper right lobe of the liver abutting the diaphragmatic surface. A subsequent positron emission tomography scan confirmed the mass and raised the possibility of another lesion in the liver raising the suspicion of malignancy. The case was complicated by the inability to perform a fine needle aspiration biopsy due to the mass’ proximity to the diaphragm. After discussion with the patient, it was decided to resect the affected liver segment. Histological analysis of the mass revealed localised necrotising granulomatous inflammation suggestive of a rheumatoid nodule, which is seldom reported in the literature.

  • hepatitis other
  • rheumatoid arthritis

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Footnotes

  • JW and SS are joint first authors.

  • Contributors Report was primarily written and edited by SS and JW who contributed equally and are co-first authors to this paper. BDB completed and wrote pathology analysis and edited the report. DX supervised this report, and reviewed and revised the final product.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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