THU0131 LOCALISATION OF RHEUMATOID LUNG NODULES IN PATIENTS WITH RHEUMATOID ARTHRITIS-RELATED INTERSTITIAL LUNG DISEASE: RIGHT OR LEFT?

Abstract

Background: The frequency of pulmonary rheumatoid nodules closely relates to the diagnostic modality and changes from Objectives: The aim of this study was to describe the general features and localisation of pulmonary rheumatoid nodules in RA-ILD patients followed up in a single tertiary center. Methods: During January 2010 and March 2019, 826 RA patients had lung computerized tomography (CT) in Hacettepe University. Three radiologists re-evaluated lung CTs and 156/826 (18.8%) patients with had RA-ILD. Pulmonary nodules suggesting pulmonary rheumatoid nodules were identified by radiologist from lung CTs. In addition to demographic, clinical and laboratory data; number of the pulmonary rheumatoid nodules, size and localisation of the biggest nodule – named as dominant nodule-, type of ILD (UIP, NSIP and isolated airway disease (AD)) were recorded. p value less than 0.05 was considered as statistically significant. Results: Of 156 patients, 68 (26, 38.2% male) patients (43.5%) had at least one pulmonary rheumatoid nodule. The mean (SD) follow-up duration was 167 (88) months for RA, and 72 (46) months for RA-ILD. Thirty patients had UIP (44.1%), 31 (45.6%) had NSIP and 7 (10.3%) had AD pattern. 35 (51.5%) of patients had exposed smoking (current or past). Rheumatoid factor and anti-CCP were positive in 60/68 (88.2%) and 33/45 (73.3%) patients, respectively. Median number of nodules was 3 (2-3). Median size of the dominant nodule was 6.8 (5.0-11.5) mm. While 41 (60.3%) of dominant nodules localised in right lung, 27 (39.7%) of dominant nodules localised in left lung (p=0.09). In addition, right inferior lobe (21, 39.9%) was the most common localisation and right middle lobe (7, 10.3%) was the least common localisation of dominant nodule (Figure 1). Conclusion: We found a high prevalence of pulmonary rheumatoid nodules in RA-ILD patients and right inferior lobe was the most common localization of dominant nodules. Prospective studies are needed to determine how the presence and localization of pulmonary rheumatoid nodules affect the RA-ILD disease process.