Rheumatoid lung nodules with "feeding-vessel" sign

Clin Rheumatol. 2021 Apr;40(4):1645-1647. doi: 10.1007/s10067-020-05351-6. Epub 2020 Aug 22.


Rheumatoid arthritis is a systemic inflammatory disease which causes symmetric polyarthritis. Lungs are common site for extra-articular involvement. Rheumatoid lung nodules occur in about 32% of patients with rheumatoid arthritis. The appearance of a lung nodule, along with the blood vessel supplying it, is called "feeding-vessel" sign on computed tomography. It is most commonly seen in infections. However, it can also be present in metastases and pulmonary vasculitis. We describe a woman with long-standing rheumatoid arthritis with subcutaneous and pulmonary nodules. Computed tomography of the chest showed "feeding-vessel" sign. There was no evidence of infection, malignancy, or vasculitis. She was treated for rheumatoid lung nodulosis with rituximab with which she improved remarkably. To the best of our knowledge, "feeding-vessel" sign in rheumatoid lung nodules has never been reported before. This case highlights the fact that "feeding-vessel" sign is not specific for pulmonary infections. It can rarely be seen in rheumatoid lung nodulosis.

Keywords: Feeding-vessel sign; Lung nodules; Rheumatoid arthritis; Rituximab.

Publication types

  • Review

MeSH terms

  • Arthritis, Rheumatoid* / complications
  • Arthritis, Rheumatoid* / diagnostic imaging
  • Arthritis, Rheumatoid* / drug therapy
  • Female
  • Humans
  • Lung / diagnostic imaging
  • Lung Diseases* / diagnostic imaging
  • Rheumatoid Nodule* / diagnostic imaging
  • Rituximab / therapeutic use


  • Rituximab