The Journal of Medical Investigation
Online ISSN : 1349-6867
Print ISSN : 1343-1420
Case reports
Pulmonary findings without the influence of therapy in a patient with rheumatoid arthritis: an autopsy case
Kiyoshi HashimotoHirofumi NakanishiAkira YamasakiHiroki ChikumiYasuyuki HasegawaMasanari WatanabeHisao ItoEiji Shimizu
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2007 Volume 54 Issue 3,4 Pages 340-344

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Abstract

We report the autopsy findings of a 40- year- old woman with lung complications of rheumatoid arthritis. She has been suffering from rheumatoid arthritis and interstitial pneumonia without satisfactory therapies because of her poor compliance. At autopsy, diffuse pleural adhesions and many protruding cysts were observed. The cut surfaces had rich fibrous changes and honey-comb like appearances dominantly in the left lower lobe. Microscopically, remarkable fibrous changes were observed with destruction of the alveolar structure. These fibroses were temporally homogeneous and lacked prominent fibroblastic foci. The histological pattern was consistent with fibrous non- specific interstitial pneumonia. In peripheral pulmonary arterioles, some thrombi were detected with much recanalization. Systemic amyloidosis was observed in the submandibular gland, thyroid, heart, and arterioles of the lung, kidney, and digestive tract. In the left pulmonary artery, a large embolus was detected. This embolism was the direct cause of death. Her pulmonary findings, except for the embolism, were considered sober states of lung complications of rheumatoid arthritis without the influence of therapy. J. Med. Invest. 54: 340-344, August, 2007

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© 2007 by The University of Tokushima Faculty of Medicine
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