Nakajima Y, Sato K, Morita H, Watanabe T, Inoue K, Kashiwazaki S
Institute of Rheumatology, Tokyo Women's Medical College.
Ryumachi. 1993 Feb;33(1):68-73.
Multicentric reticulohistiocytosis (MR) is a rare systemic disease of unknown origin that is characterized by a proliferation of histiocytes and multinucleated giant cells. Such changes in the synovium can result in a destructive arthritis, although the mechanism of arthritis in MR is poorly understood. In this paper we present three cases of MR with arthritis. In all three cases, articular symptoms preceded to skin lesions. Articular manifestations of MR were similar to those of rheumatoid arthritis; bilateral symmetric involvement, marginal erosions, and severely destructive arthritis in one case. The diagnosis was confirmed by biopsies of the cutaneous nodules and the synovial tissues of the knee joints. A light microscopic examination of the synovial tissue revealed a proliferation of histiocytes with multinucleated giant forms in the synovial stroma. Further, in one case, a proliferation of synoviocytes with a stratification of lining cells and small vessels were found in the synovium. Prednisolone was administered to all cases, though, the responses were not satisfactory. Further investigation about their clinical courses is necessary.
多中心网状组织细胞增生症（MR）是一种病因不明的罕见全身性疾病，其特征为组织细胞和多核巨细胞增殖。滑膜的这种变化可导致破坏性关节炎，尽管MR中关节炎的机制尚不清楚。在本文中，我们报告了3例伴有关节炎的MR病例。在所有3例病例中，关节症状先于皮肤病变出现。MR的关节表现与类风湿关节炎相似；双侧对称受累、边缘侵蚀，其中1例出现严重的破坏性关节炎。通过对皮肤结节和膝关节滑膜组织进行活检确诊。滑膜组织的光镜检查显示滑膜基质中组织细胞增殖并伴有多核巨细胞形成。此外，在1例病例中，滑膜中发现滑膜细胞增殖，衬里细胞分层，并有小血管。所有病例均给予泼尼松龙治疗，然而，效果并不令人满意。有必要对其临床病程进行进一步研究。
