A Case of Multicentric Reticulohistiocytosis Misdiagnosed as Rheumatoid Arthritis

Abstract

Multicentric reticulohistiocytosis (MRH) is a rare disease characterized by nodular skin lesions and severe erosive polyarthritis which is associated with malignancy in some cases. The diagnosis is confirmed by the presence of oncocytic histiocytes and multinucleated giant cells on histopathology of the cutaneous nodules and the synovial membrane. It usually remits spontaneously after 5-8 years but it can provoke destructive arthritis. We report a case of a 49-year-old female who presented with numerous nodules on the both hands, face and abdomen and progressive destructive polyarthritis of 3 years duration and has been diagnosed with rheumatoid arthritis. The lesion showed large histiocytes with ground-glass eosinophilic cytoplasm, typical of MRH. Clinical manifestation and radiological pattern of MRH may be misdiagnosed as other disease like rheumatoid arthritis and psoriatic arthritis, but histopathologic findings of our case can differentiate MRH from any other conditions.

Keywords

• multicentric reticulohistiocytosis
• rheumatoid arthritis