Munn R K, Pierce S T, Sloan D, Weeks J A
Department of Internal Medicine, University of Kentucky, Lexington, USA.
J Rheumatol. 1995 May;22(5):973-5.
We describe the case of a patient with breast cancer who developed bilateral malignant knee effusions, and review the English language literature. Patients with solid tumors who develop malignant joint effusions are rare; 27 cases have been reported (including our patient). The knee is the predominant site of joint involvement (p < 0.001). Synovial fluid (SF) analysis often demonstrates noninflammatory bloody effusion. Synovial biopsy was positive in 11 of 16 cases in which it was performed. SF cytology was positive in one half of cases in which it was obtained. Arthritis secondary to metastasis is a poor prognostic finding. A strong clinical suspicion is necessary to make the diagnosis; SF cytology or synovial biopsy can confirm it.
我们描述了一名乳腺癌患者出现双侧恶性膝关节积液的病例，并回顾了英文文献。实体瘤患者出现恶性关节积液的情况较为罕见；已报道27例（包括我们的患者）。膝关节是关节受累的主要部位（p<0.001）。滑膜液（SF）分析通常显示为非炎性血性积液。在进行滑膜活检的16例病例中，11例呈阳性。在获取滑膜液的病例中，一半病例的SF细胞学检查呈阳性。转移继发的关节炎预后不良。做出诊断需要高度的临床怀疑；SF细胞学检查或滑膜活检可以确诊。
