Kalugina Yelena, Petruzzelli Guy J, Wojcik Eva M
Department of Pathology, Loyola University Medical Center, Maywood, Illinois 60515, USA.
Diagn Cytopathol. 2003 Jun;28(6):322-4. doi: 10.1002/dc.10295.
Patients with rheumatoid arthritis may develop extra-articular subcutaneous nodules as part of the systemic disease or as initial manifestation. These lesions may represent significant diagnostic dilemmas in patients with clinical suspicion of malignancy. In this setting, fine-needle aspiration (FNA) of the nodules may be the simplest and most appropriate diagnostic approach. In the literature, however, there are only sporadic reports describing FNA cytology of a rheumatoid nodule. In this report, we present a case of a 67-year-old male with a history of rheumatoid arthritis and squamous-cell carcinoma of the larynx who developed a subcutaneous neck nodule in the immediate proximity of the surgical scar. Clinically, because of the history of squamous-cell carcinoma and location of the lesion, the nodule was suspected to be metastatic cancer, but was proven by FNA biopsy to represent rheumatoid disease. Cytological criteria of rheumatoid nodule and diagnostic difficulties are discussed.
类风湿性关节炎患者可能会出现关节外皮下结节，这是全身性疾病的一部分或初始表现。这些病变在临床怀疑为恶性肿瘤的患者中可能构成重大诊断难题。在这种情况下，对结节进行细针穿刺抽吸（FNA）可能是最简单且最合适的诊断方法。然而，在文献中，仅有零星报道描述类风湿结节的FNA细胞学检查。在本报告中，我们呈现了一例67岁男性病例，该患者有类风湿性关节炎病史及喉鳞状细胞癌病史，在手术瘢痕紧邻处出现了颈部皮下结节。临床上，由于有鳞状细胞癌病史及病变位置，该结节被怀疑为转移性癌症，但FNA活检证实为类风湿疾病。本文讨论了类风湿结节的细胞学标准及诊断难点。
