Shima Natsuki, Murosaki Takamasa, Nagashima Takao, Iwamoto Masahiro, Amano Yusuke, Nakano Naomi, Ohtsuki Mamitaro, Minota Seiji
Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan.
Department of Diagnostic Pathology, Jichi Medical University, Japan.
Intern Med. 2017;56(15):2063-2066. doi: 10.2169/internalmedicine.56.8297. Epub 2017 Aug 1.
A 68-year-old man presented with polyarthritis, proximal muscle weakness, and erythema of the face, arms, neck, and anterior chest that resembled the V-neck sign. Initially, dermatomyositis (DM) was considered because of the erythema, polyarthritis, and muscle weakness. He also had mediastinal and hilar lymphadenopathy on contrast-enhanced computed tomography. Unexpectedly, a biopsy of the forehead skin revealed numerous multinucleated giant cells. A biopsy of a solitary nodule on the dorsum of his right middle finger revealed similar multinucleated giant cells with ground-glass cytoplasm, leading to the diagnosis of multicentric reticulohistiocytosis (MRH). Although MRH is rare, it should be remembered that MRH can mimic DM.
一名68岁男性出现多关节炎、近端肌无力以及面部、手臂、颈部和前胸的红斑，类似V领征。最初，由于红斑、多关节炎和肌无力，考虑为皮肌炎（DM）。他在增强计算机断层扫描上还发现纵隔和肺门淋巴结肿大。出乎意料的是，前额皮肤活检显示有大量多核巨细胞。右手中环指背侧一个孤立结节的活检显示有类似的多核巨细胞，其细胞质呈磨砂玻璃样，从而诊断为多中心网状组织细胞增多症（MRH）。尽管MRH罕见，但应记住MRH可模仿DM。
