抄録
The purpose of the present study is to clarify the histopathological changes of the lung in 33 autopsy cases of rheumatoid arthritis, and to discuss the relationship between the pulmonary manifestations and clinical course. The results were summarized as follows:
1. Pleuritis, the most common pleuro-pulmonary lesion of patients with rheumatoid arthritis, was observed in 25 cases (78%). Twenty-two cases were associated with pleural effusion during the clinical course, but subpleural rheumatoid nodule was absent in the 33 cases.
2. Interstitial pneumonitis and diffuse interstitial fibrosis were observed in 9 cases (27.3%).
3. Granulomatous bronchitis or bronchiolitis was less frequent than diffuse interstitial fibrosis, but was considered to be important as a cause of respiratory symptoms.
4. Systemic angiitis was observed in 9 cases (27.3%), and in the lung in 5 cases. Angiitis of classical PN type was found only in the bronchial artery.
5. Pulmonary infections, such as bronchopneumonia, cytomegalic inclusion disease, pulmonary pneumocystosis, tuberculosis and so on, were observed in 13 cases. They seem to be important as one of factor determining the prognosis of patients with rheumatoid arthritis.
6. In the cases of interstitial pneumonitis and diffuse interstitial fibrosis, respiratory symptoms did not precede those of arthritis.
7. Pulmonary infections were frequently observed in cases with short clinical courses from the onset of respiratory symptoms to death, and diffuse interstitial fibrosis was found in cases with long clinical course over 9 months.
8. Caplan's syndrome and lung cancer was not found in the present study.
