Bilateral Pulmonary Cavitation as Predominant Phenotype in ANCA-Associated Disease

Abstract

A 48-year-old female ex-smoker (30 pack years) with a history of lymphocytic colitis presented to a rheumatologist due to bilateral ankle pain and finger stiffness. Based on clinical and laboratory findings, rheumatoid arthritis was diagnosed. The patient reported no respiratory symptoms and no weight loss, night sweats, or febrile episodes. However, prior to intended immunosuppressive pharmacotherapy, thoracic imaging was performed. This surprisingly revealed large cavities in both lungs (Figure). Thereupon, the patient was referred to our Department of Pulmonary Medicine.