TY - JOUR T1 - Fungus colonisation of pulmonary rheumatoid nodule JF - Journal of Clinical Pathology JO - J Clin Pathol SP - 636 LP - 637 DO - 10.1136/jcp.56.8.636 VL - 56 IS - 8 AU - A Cavazza AU - M Paci AU - E Turrini AU - R Dallari AU - G Rossi Y1 - 2003/08/01 UR - http://jcp.bmj.com/content/56/8/636.abstract N2 - 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. ER -