Gallay L, Streichenberger N, Benveniste O, Allenbach Y
Centre de pathologie et neuropathologie Est, hospices civils de Lyon, 69004 Lyon, France; Institut neuromyogène, CNRS UMR 5310, Inserm U1217, 69622 Villerbanne, France.
Centre de pathologie et neuropathologie Est, hospices civils de Lyon, 69004 Lyon, France; Institut neuromyogène, CNRS UMR 5310, Inserm U1217, 69622 Villerbanne, France; Université Claude-Bernard-Lyon 1, 69622 Villerbanne, France.
Rev Med Interne. 2017 Oct;38(10):679-684. doi: 10.1016/j.revmed.2017.06.015. Epub 2017 Sep 22.
Focal myositis are inflammatory muscle diseases of unknown origin. At the opposite from the other idiopathic inflammatory myopathies, they are restricted to a single muscle or to a muscle group. They are not associated with extramuscular manifestations, and they have a good prognosis without any treatment. They are characterized by a localized swelling affecting mostly lower limbs. The pseudo-tumor can be painful, but is not associated with a muscle weakness. Creatine kinase level is normal. Muscle MRI shows an inflammation restricted to a muscle or a muscle group. Muscle biopsy and pathological analysis remain necessary for the diagnosis, showing inflammatory infiltrates composed by macrophages and lymphocytes without any specific distribution within the muscle. Focal overexpression of HLA-1 by the muscle fibers is frequently observed. The muscle biopsy permits to rule out differential diagnosis such a malignancy (sarcoma). Spontaneous remission occurs within weeks or months after the first symptoms, relapse is unusual.
局灶性肌炎是病因不明的炎性肌肉疾病。与其他特发性炎性肌病不同,它们局限于单一肌肉或肌肉群。它们不伴有肌肉外表现,未经任何治疗也有良好的预后。其特征为局限性肿胀,主要影响下肢。假肿瘤可能疼痛,但与肌无力无关。肌酸激酶水平正常。肌肉磁共振成像显示炎症局限于一块肌肉或一个肌肉群。肌肉活检和病理分析对于诊断仍然必要,显示由巨噬细胞和淋巴细胞组成的炎性浸润,在肌肉内无任何特定分布。经常观察到肌纤维HLA-1的局灶性过表达。肌肉活检有助于排除诸如恶性肿瘤(肉瘤)等鉴别诊断。自发缓解在首次出现症状后的数周或数月内发生,复发不常见。