Cegarra-Escolano M, Jaloux C, Camuzard O
Department of Plastic and Reconstructive Surgery, University Center of Nice, Pasteur II Hospital, 30, voie Romaine, 06001 Nice, France.
Department of Plastic and Reconstructive Surgery, University Center of Marseille, Conception Hospital, 147, boulevard Baille, 13005 Marseille, France.
Hand Surg Rehabil. 2018 May 18. doi: 10.1016/j.hansur.2018.03.005.
Rice bodies are very unusual lesions, generally encountered in chronic synovitis due to rheumatoid diseases or tuberculosis. A 31-year-old right-handed man presented with a 15-year history of progressively growing "sausage-like" swelling of the 4th finger and palm of his right hand. There was an immovable, painless mass with restriction of the finger's ROM without local or general associated signs. Imaging showed a large non-aggressive mass within the tendon sheath. Complete excision of the mass was performed. Histopathological examination showed synovial villi with rice bodies and central necrosis suggestive of tuberculous synovitis or rheumatoid arthritis (RA). Tests for mycobacterial infections were all negative and there was no argument in favor of a rheumatoid pathology. There is no established standard treatment in a case like ours, which has no origin in tuberculosis or RA. Prolonged follow-up will be needed to confirm absence of recurrence after complete excision.
米粒体是非常罕见的病变，通常见于类风湿性疾病或结核病引起的慢性滑膜炎。一名31岁右利手男性，右手第4指和手掌出现进行性增大的“腊肠样”肿胀15年。有一个固定不动、无痛的肿块，手指活动范围受限，无局部或全身相关体征。影像学显示腱鞘内有一个较大的非侵袭性肿块。对肿块进行了完整切除。组织病理学检查显示滑膜绒毛伴有米粒体和中央坏死，提示结核性滑膜炎或类风湿关节炎（RA）。分枝杆菌感染检测均为阴性，且无支持类风湿病理的依据。像我们这样并非由结核或RA引起的病例，尚无既定的标准治疗方法。需要长期随访以确认完整切除后无复发。
