Presentation
Former coal miner with known rheumatoid disease. Follow up of know chest condition.
Patient Data
Emphysematous changes in both upper lobes.
Occasional small nodules, such as projected over the right 6th and left 2nd anterior ribs.
No pleural thickening.
Heart size normal.
Emphysematous change at both lung apices.
Multiple bilateral sub-pleural and parenchymal nodules, the largest is in the left upper lobe and measures 2 cm.
Bilateral lower lobe subpleural reticular change and early honeycomb formation, in addition to a degree of dependent density change.
No pleural thickening or calcification.
Case Discussion
This patient was a former coal-miner and additionally suffers from rheumatoid disease.
The lungs are fibrotic, but not in the upper lobe fashion typically associated with pneumoconiosis. In addition multiple nodules are present, which were unchanged over time-interval studies.
The emphysematous changes relates to a prior history of smoking.
A prior biopsy was performed and said to be fitting with the infamous membership exam condition of Caplan's syndrome.
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