Lawton A W, Karesh J W
Surv Ophthalmol. 1987 Jan-Feb;31(4):285-90. doi: 10.1016/0039-6257(87)90029-4.
A 2-year-old boy presented with a 3-month history of nontender masses involving the right superotemporal orbit and scalp. Over the three-week period before presentation he also developed nodules on his wrist, abdomen, and buttocks. The remainder of the ocular and general physical exam was unremarkable. A biopsy of the right orbital mass demonstrated stellate areas of collagen necrosis surrounded by pallisading epithelioid histiocytes and scattered multinucleated giant cells. Special stains for connective tissue mucin were positive in the areas of necrosis. The diagnosis reached pathologically and clinically were that of pseudorheumatoid nodules and granuloma annulare syndrome respectively. These two diagnostic terms have been used independently in the ophthalmologic and dermatologic literature, despite the identical histologic and clinical behaviors seen by both medical groups. A unified nomenclature system of pseudorheumatoid nodule for the histopathology of an individual lesion and granuloma annulare for the syndrome is suggested.
一名2岁男孩出现右侧颞上眼眶和头皮无痛性肿块3个月。在就诊前的三周内，他的手腕、腹部和臀部也出现了结节。眼部和全身体格检查的其余部分无异常。右侧眼眶肿块活检显示胶原坏死的星状区域，周围有栅栏状上皮样组织细胞和散在的多核巨细胞。结缔组织粘蛋白的特殊染色在坏死区域呈阳性。病理诊断和临床诊断分别为假类风湿结节和环形肉芽肿综合征。尽管两个医学组观察到相同的组织学和临床特征，但这两个诊断术语在眼科和皮肤科文献中一直独立使用。建议针对单个病变的组织病理学采用假类风湿结节的统一命名系统，针对该综合征采用环形肉芽肿的统一命名系统。
