Spadaro A, Riccieri V, Sili-Scavalli A, Innocenzi D, Pranteda G, Taccari E
Institut de Rhumatologie, Université La Sapienza, Rome, Italie.
Rev Rhum Ed Fr. 1994;61(7-8):554-7.
The authors report the case of a patient who had both multicentric reticulohistiocytosis--a systemic disease characterized by symmetric polyarthritis and papulonodular skin lesions--and an ovarian adenocarcinoma. Synovial fluid analysis found histiocytes with a ground-glass cytoplasm, binucleate giant cells, and undifferentiated cells undergoing mitosis. PAS-positive, diastase-resistant cells similar to the synovial fluid histiocytes were seen in the synovial and cutaneous biopsy specimens. These findings established the diagnosis of multicentric reticulohistiocytosis and suggested an underlying malignancy. Whether or not multicentric reticulohistiocytosis is a paraneoplastic syndrome remains unsettled. However, our report provides evidence that synovial fluid analysis can be helpful not only for the early diagnosis of multicentric reticulohistiocytosis but also for suggesting the presence of an underlying tumor, especially when arthritis is the presenting symptom.
作者报告了一例同时患有多中心性网状组织细胞增生症（一种以对称性多关节炎和丘疹结节性皮肤损害为特征的全身性疾病）和卵巢腺癌的患者。滑液分析发现有磨砂玻璃样细胞质的组织细胞、双核巨细胞以及正在进行有丝分裂的未分化细胞。在滑膜和皮肤活检标本中可见到与滑液组织细胞相似的PAS阳性、抗淀粉酶细胞。这些发现确立了多中心性网状组织细胞增生症的诊断，并提示存在潜在的恶性肿瘤。多中心性网状组织细胞增生症是否为副肿瘤综合征仍未明确。然而，我们的报告提供了证据表明，滑液分析不仅有助于多中心性网状组织细胞增生症的早期诊断，还能提示潜在肿瘤的存在，尤其是当关节炎为首发症状时。
