Rheumatoid arthritis

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Rheumatoid arthritis, commonly abbreviated RA, is an autoimmune disorder.

Skin

General

  • May manifest as rheumatoid neutrophilic dermatitis - super rare.[1]

Microscopic

Features:

Joint with rheumatic disease

  • AKA rheumatic joint disease.

General

Clinical:

  • Tumour - swelling.
  • Rubor - redness.
  • Calor - heat.
  • Dolor - pain.

Microscopic

Features:[2]

  • Chronic inflammation, esp. lymphocytes.
    • +/-Lymphoid follicles.
  • Synovial hyperplasia - with papillary or polyoid architecture.
    • Synoviocytes may show binucleation and mild atypia.
  • +/-Fibrin.
  • +/-Bone.
  • +/-Cartilage.

Note:

Images:

Rheumatoid nodule

General

  • Usually only in seropositive cases.[4]

Microscopic

Features:[4][5]

  • Necrotic collagen bundles with fibrin surrounded by:
  • +/-Eosinophils.

Notes:

DDx:

Images:

Pleural disease

See Rheumatoid pleuritis.

Lung disease

See Medical lung disease.

RA may involve the lung.

Amyloidosis

See Amyloidosis.

Amyloidosis may be due to RA.

Felty syndrome

RA may occur in Felty syndrome -- the triad:[8]

Felty syndrome is associated with large granular lymphocytic leukemia.[8][9]

See also

References

  1. Mashek, HA.; Pham, CT.; Helm, TN.; Klaus, M. (Jun 1997). "Rheumatoid neutrophilic dermatitis.". Arch Dermatol 133 (6): 757-60. PMID 9197831.
  2. Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 660. ISBN 978-0781765275.
  3. URL: http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/msfrm.html. Accessed on: 5 December 2010.
  4. 4.0 4.1 Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 299. ISBN 978-0470519035.
  5. 5.0 5.1 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 52. ISBN 978-0443066542.
  6. 6.0 6.1 URL: http://granuloma.homestead.com/palisading.html. Accessed on: 1 November 2010.
  7. URL: http://www.pathguy.com/lectures/joints.htm. Accessed on: 1 November 2010.
  8. 8.0 8.1 Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 328. ISBN 978-1416054542.
  9. Liu, X.; Loughran, TP. (Jul 2011). "The spectrum of large granular lymphocyte leukemia and Felty's syndrome.". Curr Opin Hematol 18 (4): 254-9. doi:10.1097/MOH.0b013e32834760fb. PMID 21546829.

External links