Chest Imaging

Caplan's syndrome

(Anthony Caplan, 1907-1976, British physician), condition originally described in 1953 in coal miners and characterized by the presence of one or more well-defined nodular opacities in the lungs. These lesions have a diameter of between 1 and 5 cm and, in contrast to progressive massive fibrosis (PMF), develop rapidly. It has been hypothesized that these lesions represent a hypersensitivity reaction to the irritating dust particles in the lungs of rheumatoid arthritis patients who are already hyperimmune. During the course of the disease these nodules may remain unchanged, increase in number, cavitate or calcify (Fig.1). Sometimes they disappear. The nodules can appear before, during or after the clinical onset of arthritis. Often the background of pneumoconiosis is slight or even absent.

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Fig.1

HRCT scan in a patient with rheumatoid arthritis and silicosis demonstrates bilateral peripheral lung nodules, and emphysema associated with a large cavitated lung nodule.
Caplan's syndrome, Fig.1