de Haas W H, van Heerde P
Z Rheumatol. 1979 Sep-Oct;38(9-10):318-29.
In the embryo the periarticular fibroblasts were the producers of the greater part of the joint they surround in later life, as well as of the tendon sheaths and bursae. It is postulated that adult fibroblasts have retained atavistic arthrogenic properties, and may react to traumatizing, inflammatory and oncogenic stimuli by forming periarticular joint-like structures: "arthromas" such as ganglia, meniscal cysts, synovial cysts, synovial sarcoma and subcutaneous nodules. The arthroid nature of these growths manifests itself by the presence of a central cavity, which can be identified as a synovial cavity by histologic, histochemical and electron-microscopic methods. In case of affection of the joint all of these adnexa may be involved. A resemblance of these structures to embryonic joint tissues has been noted for years. The nature of the subcutaneous nodule is discussed at some length. It may contain one or more synovial clefts; synovial elements may be found in its centre by histochemistry and electron-microscopy. Recent and personal findings shed a new light on palisading cells, which may be fibroblasts, having taken up again their embryonic task as synovioblasts. From periarticular fibroblasts thus three kinds of tumors may arise; benign (ganglia, cysts, subcutaneous nodules), malignant (synovial sarcoma) and "semi-malignant" (pannus in rheumatoid arthritis).
在胚胎期，关节周围的成纤维细胞是其在后期所环绕关节的大部分组织、肌腱腱鞘和滑囊的产生者。据推测，成年成纤维细胞保留了返祖性的致关节形成特性，并且可能通过形成关节周围类似关节的结构来对创伤、炎症和致癌刺激作出反应，这些结构包括腱鞘囊肿、半月板囊肿、滑膜囊肿、滑膜肉瘤和皮下结节等“关节瘤”。这些肿物的类关节性质通过中央腔的存在得以体现，通过组织学、组织化学和电子显微镜方法可将其识别为滑膜腔。若关节受累，所有这些附属结构都可能被累及。多年来人们一直注意到这些结构与胚胎关节组织的相似性。文中对皮下结节的性质进行了较为详细的讨论。它可能包含一个或多个滑膜裂隙；通过组织化学和电子显微镜检查可在其中心发现滑膜成分。近期的个人研究结果为栅栏状细胞带来了新的认识，这些细胞可能是成纤维细胞，重新承担起了它们作为滑膜成纤维细胞的胚胎期任务。因此，关节周围的成纤维细胞可能引发三种肿瘤：良性肿瘤（腱鞘囊肿、囊肿、皮下结节）、恶性肿瘤（滑膜肉瘤）和“半恶性”肿瘤（类风湿关节炎中的血管翳）。
