Article Text

Download PDFPDF
Fungus colonisation of pulmonary rheumatoid nodule
  1. A Cavazza1,
  2. M Paci2,
  3. E Turrini3,
  4. R Dallari3,
  5. G Rossi4
  1. 1Department of Pathology, S. Maria Nuova Hospital, Viale Risorgimento 80, 42100 Reggio Emilia, Italy
  2. 2Department of Thoracic Surgery, S. Maria Nuova Hospital
  3. 3Department of Internal Medicine, Sassuolo Hospital, 41049 Sassuolo (Modena), Italy
  4. 4Department of Pathology, University of Modena, 41100 Modena, Italy
  1. Correspondence to:
 Dr A Cavazza, Unità Operativa di Anatomia Patologica, Ospedale S. Maria Nuova, Viale Risorgimento 80, 42100 Reggio Emilia, Italy; 


This report describes a 69 year old woman, suffering from active rheumatoid arthritis since the age of 60 and presenting with severe dyspnoea and cough. A computed tomography scan of the chest showed multiple bilateral pulmonary nodules, sometimes cavitated, associated with reticular opacities and pleural effusion. A videothoracoscopic excision of a cavitated nodule was performed. Seven days after surgery, a right pneumothorax developed, and the patient died of septicaemia one month later. Microscopically, the excised nodule was composed of necrotic fibrinoid material with a peripheral rim of palisaded histiocytes, extending to the pleural surface and containing several fungal hyphae morphologically consistent with aspergillus. A diagnosis of pulmonary rheumatoid nodule with fungus colonisation was made. In the lung, fungus colonisation is a rare complication of rheumatoid nodules. The most important differential diagnostic considerations are briefly discussed.

  • rheumatoid nodule
  • aspergillus
  • lung
  • bronchopleural fistula

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.