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Zero-negative RA New diagnosis lung nodule
Hi, I am a 60 six-year-old woman with a history of on and off smoking. I am DNA positive for zero negative rheumatoid arthritis that is relentless. It goes into somewhat of a remission during infusions but on a daily basis, it’s annoying at its best. I have been having shortness of breath, which came on very fast and I’d say over a one month period and hoarseness when I talk a lot and I ended up going to the ER at the request of my doctor because my blood pressure was extremely high and my heart rate was very high and they did a chest x-ray because of the shortness of breath and found a lung nodule which they followed up immediately with a CAT scan, which showed a 1.4 cm x 1.0 cm nodule right upper lobe with irregular edges and irregular opacity. Primary care already scheduled follow up ct scan for 3 months and cardiology in 2 weeks. Pulmonary hypertension also showed up on ct scan.
I had a previous chest x-ray eight months ago because of shortness of breath and it was clear as was my chest x-ray the year before was also clear I am wondering if it’s a pulmonary nodule starting the RA lung issues. Any input welcome. Thank you.
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It should read Seronegative!!!
Visually impaired and I use talk to text.
Hi, @breakingbad mom!
With a strongly positive anti-CCP, guess I would be considered seropositive for RA. At age 65 an incidental 1.2 cm lung nodule was found on my CT cardiac scan, which one lung specialist described as solid, spiculated, and I believe non-calcified — although there was some disagreement as to whether or not there was any cause for alarm, as the radiologist was convinced the nodule was merely somewhat irregular in shape. It being in the upper lobe seemed to be a good thing, as apparently more cancer seems to occur in the lower lobes. After much back and forth, a needle biopsy was done, and the nodule was found to be completely benign. Although I had had much secondhand exposure to smoking as a child, no smoking history of my own. Apparently, the nodule was only a remnant of scar tissue. A true rhematoid nodule has a different histopathology, being composed of dead tissue and fibrin at its core, a wall of elongated immune cells, and inflammatory cells on its outer layer. Kind of doubt they can determine this without a needle biopsy. And with your history of smoking, they might want to be extra watchful.
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2 ReactionsThank you. 🙂
Since I have nodules on my lung and nobody has been able to definitively identify exactly what it is, I don’t know how to proceed. I have one nodule and two masses in my lungs and six weeks ago started on Humira along with the Leflunomide. Are there any medical resources where we can find more answers? I have had shortness of breath and have RA in my neck.
@rheumatol3 Lung nodules and masses need to be screened by a pulmonologist to determine next steps.
Have you seen a pulmonologist?
@sueinmn Hi, I have not. I see cardiology in 2 weeks and my primary doctor seems to think cardiology will work with pulmonary on this. My next step should it worsen before cardiology appointment is to get to the ER.
Primary care is under the impression that cardiology will do pulmonary function studies because of the pulmonary hypertension affecting my blood pressure and heart rate it is a nightmare. It is an overwhelming, sad, depressing, nightmare. I don’t know how you all do it, but this is rough.
@breakingbadmom Please be sure to get a pulmonology referral from the cardiologist. I guess my issues occurred in a different order, pulmonary issues came first, later the diagnosis of coronary artery disease. In one case, my primary sent me to the pulmonologist. In the other, an Urgent Care to ER trip earned me a cardiologist on my team. In the odd world of medicine, it was my pulmonologist who sent me to rheumatologist because she thought my new, young PCP had missed something - and she was right.