Pancreatic Rheumatoid Granulomas: A Case Report of a Rare Complication of Rheumatoid Arthritis.

Publication/Presentation Date

7-1-2021

Abstract

Cutaneous granulomas presenting as skin nodules are the most common extra-articular manifestations of rheumatoid arthritis (RA). Granulomas are defined as a form of chronic inflammatory response characterized by aggregation of activated histiocytes. Visceral granulomas are a rare complication of long-standing RA and have been described twice in the literature. We report a case of a 55-year-old woman with a 15-year history of RA. The patient presented with epigastric pain and weight loss. Imaging studies showed a large soft tissue mass in the head of the pancreas, which was suspected to be malignant. A Whipple procedure was performed, and histological examination revealed multiple non-caseating granulomas with central liquefaction and neutrophilic infiltrate. Ziehl-Neelsen stain for acid-fast bacilli and tuberculosis polymerase chain reaction were negative. The patients' granulomas were diagnosed as rheumatoid granulomas. Five years after diagnosis, the patient is doing well and has no complications.

Volume

36

Issue

4

First Page

291

Last Page

291

ISSN

1999-768X

Disciplines

Medicine and Health Sciences

PubMedID

34447584

Department(s)

Fellows and Residents

Document Type

Article

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