Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Caplan Syndrome Mimicking Progressive Massive Fibrosis on CT: A Case Report

CT에서 가속화된 진행성거대섬유증으로 오인된 카플란 증후군: 증례 보고

  • Jinwook Baek (Department of Radiology, Inje University Busan Paik Hospital) ;
  • Ji-Yeon Han (Department of Radiology, Inje University Busan Paik Hospital)
  • 백진욱 (인제대학교 부산백병원 영상의학과) ;
  • 한지연 (인제대학교 부산백병원 영상의학과)
  • Received : 2023.10.23
  • Accepted : 2024.03.15
  • Published : 2024.07.01
Download PDF
⟨ Previous Next ⟩

Abstract

This report presents a unique case of Caplan syndrome that mimicked accelerated progressive massive fibrosis. The patient, a former coal miner, had been diagnosed with coal worker's pneumoconiosis 15 years prior and had been treated for rheumatoid arthritis for over 20 years. Accelerated progressive massive fibrosis and the development of multiple nodules with cavitation in the basal lungs were subsequently observed on serial CT scans. Here, the CT manifestations of Caplan syndrome are highlighted in a case in which Caplan syndrome mimicked accelerated progressive massive fibrosis.

본 증례 보고에서는 가속화된 진행성거대섬유증으로 오인된 카플란 증후군을 소개한다. 환자는 15년 전 탄광부진폐증을 진단받고 20년 이상 류마티스관절염 치료를 받은 자로 연속적인 CT 검사에서 진행거대섬유증의 진행과 함께 폐기저부에 동공을 동반한 다발성 폐결절이 관찰되었다. CT상 가속화된 진행성거대섬유증 소견으로 오인할 수 있는 카플란 증후군 증례를 보고하고자 한다.

Keywords

Acknowledgement

Ms. Ho Jin Jung, M.D., Department of Pathology, Inje University Busan Paik Hospital, Korea, provided the histopathological images of this case.

References

  1. Schreiber J, Koschel D, Kekow J, Waldburg N, Goette A, Merget R. Rheumatoid pneumoconiosis (Caplan's syndrome). Eur J Intern Med 2010;21:168-172
  2. Walker CM, Chung JH. Muller's imaging of the chest. 2nd ed. Philadelphia: Elsevier 2019:774-834
  3. Armstrong P, Wilson AG, Dee P, Hansell DM. Imaging of diseases of the chest. 2nd ed. St. Louis: Mosby 1995:391-440
  4. Arakawa H, Honma K, Shida H, Saito Y, Morikubo H. Computed tomography findings of Caplan syndrome. J Comput Assist Tomogr 2003;27:758-760
  5. Saavedra FT, Sierra LL, Zuluaica AM, Botero EC. Diagnosing Caplan syndrome in a patient with silicosis and rheumatoid arthritis: imaging shows miliary pattern and cavity lung lesions. Lancet 2023;401:2148
  6. Groner LK, Green DB, Weisman SV, Legasto AC, Toy D, Gruden JF, et al. Thoracic manifestations of rheumatoid arthritis. Radiographics 2021;41:32-55
  7. Jun JS, Jung JI, Kim HR, Ahn MI, Han DH, Ko JM, et al. Complications of pneumoconiosis: radiologic overview. Eur J Radiol 2013;82:1819-1830
  8. Fareez F, Moodley J, Popovic S, Lu JQ. Rheumatoid nodules: a narrative review of histopathological progression and diagnostic consideration. Clin Rheumatol 2023;42:1753-1765
  9. Prete M, Racanelli V, Digiglio L, Vacca A, Dammacco F, Perosa F. Extra-articular manifestations of rheumatoid arthritis: an update. Autoimmun Rev 2011;11:123-131
  10. Almberg KS, Friedman LS, Rose CS, Go LHT, Cohen RA. Progression of coal workers' pneumoconiosis absent further exposure. Occup Environ Med 2020;77:748-751