Lung biopsy in rheumatoid arthritis

Am Rev Respir Dis. 1985 May;131(5):770-7. doi: 10.1164/arrd.1985.131.5.770.


Forty open lung biopsies from patients with rheumatoid arthritis and possible "rheumatoid lung disease" were reviewed in an attempt to correlate histology with radiologic, physiologic, and prognostic variables. A wide variety of histopathologic features was seen, and primary and secondary patterns of injury were recognized. Five different groups based on histologic patterns were identified: pulmonary rheumatoid nodules, usual interstitial pneumonia (UIP), bronchiolitis obliterans with patchy organizing pneumonia (BOOP), lymphoid hyperplasia, and cellular interstitial infiltrates. The finding of rheumatoid nodules as the primary pattern imparted a uniformly good prognosis, whereas the pattern of UIP indicated a poor one. Patients with BOOP had a more favorable prognosis than did patients with UIP, as did patients with lymphoid hyperplasia and/or nonspecific cellular interstitial infiltrates. Consistent correlations between pulmonary function testing and roentgenographic and histologic findings were not found. The term "rheumatoid lung disease" is of no use as a histologic diagnosis because it encompasses a broad spectrum of morphologic changes that carry significantly different prognoses.

MeSH terms

  • Antibodies, Antinuclear / analysis
  • Arthritis, Rheumatoid / drug therapy
  • Arthritis, Rheumatoid / pathology*
  • Biopsy
  • Female
  • Gold / therapeutic use
  • Humans
  • Lung / pathology*
  • Lung / physiopathology
  • Lung Diseases / complications
  • Lung Diseases / pathology
  • Male
  • Middle Aged
  • Penicillamine / therapeutic use
  • Prognosis
  • Radiography, Thoracic
  • Respiratory Function Tests
  • Rheumatoid Factor / analysis
  • Rheumatoid Nodule / pathology


  • Antibodies, Antinuclear
  • Gold
  • Rheumatoid Factor
  • Penicillamine