Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Caplan's Syndrome Presenting as Multiple Pulmonary Nodules

다발성 폐결절로 발견된 카플란증후군 1예

  • Lee, Sang-Kook (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Sang-Hoon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Song-Yee (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Woo-Kyung (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Shin, Dong-Ho (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Bang, Woo-Dae (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Noh, Song-Mi (Department of Pathology, Yonsei University College of Medicine) ;
  • Shim, Hyo-Sup (Department of Pathology, Yonsei University College of Medicine) ;
  • Park, Byung-Hoon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Kyung-Jong (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Park, Moo-Suk (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Young-Sam (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Chang, Joon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Se-Kyu (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kang, Young-Ae (Department of Internal Medicine, Yonsei University College of Medicine)
  • 이상국 (연세대학교 의과대학 내과학교실) ;
  • 이상훈 (연세대학교 의과대학 내과학교실) ;
  • 김송이 (연세대학교 의과대학 내과학교실) ;
  • 이우경 (연세대학교 의과대학 내과학교실) ;
  • 신동호 (연세대학교 의과대학 내과학교실) ;
  • 방우대 (연세대학교 의과대학 내과학교실) ;
  • 노송미 (연세대학교 의과대학 병리학교실) ;
  • 심효섭 (연세대학교 의과대학 병리학교실) ;
  • 박병훈 (연세대학교 의과대학 내과학교실) ;
  • 이경종 (연세대학교 의과대학 내과학교실) ;
  • 박무석 (연세대학교 의과대학 내과학교실) ;
  • 김영삼 (연세대학교 의과대학 내과학교실) ;
  • 장준 (연세대학교 의과대학 내과학교실) ;
  • 김세규 (연세대학교 의과대학 내과학교실) ;
  • 강영애 (연세대학교 의과대학 내과학교실)
  • Received : 2010.06.12
  • Accepted : 2010.07.23
  • Published : 2011.02.28
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Abstract

We report a case of Caplan's Syndrome, which presented as multiple pulmonary nodules. A 58-year-old male was admitted to hospital due to multiple pulmonary nodules. In addition, the patient presented with multiple arthritis, and dyspnea on exertion. Rheumatoid arthritis had been diagnosed 35 years ago. The patient had worked as a stonemason for 20 years. Computed Tomography (CT) revealed numerous well-defined tiny nodules scattered in both lungs, which was suspicious of miliary tuberculosis or malignancy. The patient was started on antituberculous medications and referred to our hospital. First, a transbronchial lung biopsy was performed, which showed no evidence of granuloma. It was our opinion that the biopsy was insufficient, and a follow-up video-associated thoracoscopy was performed. The pathological report determined necrotizing granulomatous inflammation and silicosis on background. According to imaging studies, pathologic reports, and clinical symptoms, we concluded that the patient had Caplan's syndrome. We controlled his rheumatic medications, and instructed him to avoid exposure to hazardous dust.

Keywords

References

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