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Facts about the skin from DermNet New Zealand Trust. Topic index: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


Rheumatoid nodule pathology

Histology of rheumatoid nodule

In a rheumatoid nodule, scanning power view reveals a granulomatous tissue reaction pattern (Figure 1). Well formed necrobiotic granulomas form within the dermis frequently with deep extension (Figure 2). There is a surrounding palisade of histiocytes and a mixed infiltrate of lymphocytes, plasma cells, multinucleated giant cells and occasional eosinophils (Figure 3).

Rheumatoid nodule pathology Rheumatoid nodule pathology Rheumatoid nodule pathology
Rheumatoid nodule pathology

Special stains in rheumatoid nodule

Additional staining for fungal infections and mycobacteria should be considered in all significant granulomatous infiltrates.

Differential diagnosis of rheumatoid nodule

Deep granuloma annulare: The necrobiotic centres in rheumatoid nodules tend to demonstrate a bright eosinophilic consistency, whereas in granuloma annulare mucin deposition may be seen imparting a basophilic tinge.

Draft 14 February 2010

Related information

References:

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Other websites:

Rheumatoid Arthritis – eMedicine Rheumatology

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Author: Dr Ben Tallon, Dermatologist/Dermatopathologist, Tauranga, New Zealand.

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