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rheumatoid nodule

骨科

关键词骨科 疾病 基础研究

词汇介绍

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解析

rheumatoid    /'ruːmətɒɪd/  /'rʊmətɔɪd/

         n. [] 类风湿病的

同根词     adj.rheumatic 风湿病的;风湿病引起的

n.

rheumatism [内科] 风湿病

rheumatic 风湿病;风湿病患者

rheumatology 风湿病学

        A rheumatoid nodule is a local swelling or tissue lump, usually rather firm to touch, like an unripe fruit, which occurs almost exclusively in association with rheumatoid arthritis.

类风湿结节是一种局部肿胀或组织肿块,通常摸起来很硬,就像未成熟的水果,几乎只与类风湿关节炎有关。

概述

一、疾病概述或定义类风湿结节(Rheumatoid nodule,RN)为RA常见关节外表现,其发生率报道为2.1-38.2%,合并有Felty综合征的RA患者RN发病率高达75%,好发于男性,因种族及地域RN发病率不同,高加索人群高发,RN在白种人群中发病率相对较高,报道白种人RN发生率20-30%,亚洲人中为2-5%。基因在RN中有一定作用。携带HLA-DR4、DRBl患者RN出现率高、杂合子HLADRBl者发生RN的风险高,HLA-DRw2基因者RN发病率低、RF低滴度。也有研究发现白种人

Clinicopathologic features of rheumatoid nodules: a retrospective analysis复制标题

类风湿结节临床病理特征回顾性分析

发表时间:2019-07-04

影响因子:2.3

作者: Bang S

期刊:Clin. Rheumatol

A rheumatoid nodule is the most common extra-articular manifestation and characteristic lesion in rheumatoid arthritis (RA) patients. This is mainly manifested as a cutaneous mass; however, it can arise in various non-cutaneous sites such as the lung, tendon, vocal cord, occiput, and sacrum. The diagnosis of rheumatoid nodules is usually determined clinically with typical clinical characteristics without requiring additional diagnostic testing. However, if there is uncertainty in the diagnosis, distinct histologic features of rheumatoid nodules should be confirmed by excisional biopsy. Rheumatoid nodules in the lung, which is a commonly affected site of noncutaneous rheumatoid nodules, can mimic infections such as tuberculosis, or neoplastic diseases.Necrobiosis, with fibrin deposition and palisading epithelioid histiocytes, is a typical histologic feature of rheumatoid nodules. The area of central necrosis contains necrotizing endothelial cells and histiocytes. The outer area tends to show granulation tissues with chronic inflammatory cells and significant stromal fibrosis. Focal vasculitis and occasional giant cells can also be found. Overall, the histologic appearance of rheumatoid nodules is representative of an immunemediated granulomatous process. These surrounding palisading epithelioid histiocytes are antigen-presenting cells testing positive for human leucocyte antigen–DR isotype (HLA-DR) and were found to secrete interleukin (IL)-1, tumor necrosis factor (TNF), interferon, IL-10, IL-15, IL-18, and IL-12 in other studies.

译文

类风湿结节是类风湿性关节炎(RA)患者中最常见的关节外表现和特征性损伤。这主要表现为皮肤肿块;然而,它可以出现在各种非皮肤部位,例如肺,肌腱,声带,枕骨和骶骨。类风湿结节的诊断通常在临床上通过典型的临床特征确定,无需额外的诊断测试。然而,如果诊断存在不确定性,应通过切除活检确认类风湿结节的独特组织学特征。肺部的类风湿结节是非皮肤类风湿结节的常见影响部位,可以模拟结核病或肿瘤性疾病等感染。具有纤维蛋白沉积和栅栏上皮样组织细胞的坏死性疾病是类风湿结节的典型组织学特征。中央坏死区域含有坏死的内皮细胞和组织细胞。外部区域倾向于显示具有慢性炎性细胞和显着的间质纤维化的肉芽组织。也可以发现局灶性血管炎和偶尔的巨细胞。总体而言,类风湿结节的组织学表现代表了免疫介导的肉芽肿过程。这些周围栅栏上皮样组织细胞是检测人白细胞抗原-DR同种型(HLA-DR)阳性的抗原呈递细胞,被发现分泌白细胞介素(IL)-1,肿瘤坏死因子(TNF),干扰素,IL-10,IL -15,IL-18和IL-12在其他研究中。