Caplan syndrome

Case contributed by Dr Ian Bickle

Presentation

Former coal miner with known rheumatoid disease. Follow up of know chest condition.

Patient Data

Age: 70 years
Gender: Male
X-ray

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.

CT

Emphysematous change at both lung apices.

Multiple bilateral sub-pleural and parenchymal nodules, the largest 2cm in the left upper lobe.

Bilateral lower lobe sub-pleural reticular change and early honeycomb formation, in addition to a degree of dependent density change.

No pleural thickening of 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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Case information

rID: 56667
Case created: 15th Nov 2017
Last edited: 1st Dec 2017
System: Chest
Inclusion in quiz mode: Included
Institution: Rotherham Foundation Hospital Trust

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