Limits...
Rheumatoid arthritis mimicking metastatic squamous cell carcinoma.

Gomez-Rivera F, El-Naggar AK, Guha-Thakurta N, Kupferman ME - Head Neck Oncol (2011)

Bottom Line: Imaging demonstrated a 1.4 cm cystic lesion at the hyoid bone.A trans-cervical approach was used.Pathology revealed a necrotizing granuloma compatible with rheumatoid etiology.

View Article: PubMed Central - HTML - PubMed

Affiliation: Otorhinolaryngology - Head and Neck Surgery/Otolaryngology, The University of Houston Health Science Center, Houston, Texas, USA.

ABSTRACT
We report a case of a cervical rheumatoid nodule in close relation to the hyoid bone mimicking a metastatic carcinoma. A 74-year-old female with a 15-year history of rheumatoid arthritis (RA) on treatment with methotrexate presented with tenderness of the right base of tongue. Imaging demonstrated a 1.4 cm cystic lesion at the hyoid bone. Biopsies were unsuccessful and the patient required surgical resection of the mass. A trans-cervical approach was used. Pathology revealed a necrotizing granuloma compatible with rheumatoid etiology. The clinician should be aware that, in a patient with a neck mass, in the presence of active RA, rheumatoid nodules should be part of the differential diagnosis.

Show MeSH

Related in: MedlinePlus

Photomicroscopy. The lesion composed of multiple irregular, fairly demarcated nodules with central eosinophilic necrosis (×20) lined by thick peripheral layer of palisading mono-nuclear cells (inset ×40) characteristic of rheumatoid nodules.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3118955&req=5

Figure 2: Photomicroscopy. The lesion composed of multiple irregular, fairly demarcated nodules with central eosinophilic necrosis (×20) lined by thick peripheral layer of palisading mono-nuclear cells (inset ×40) characteristic of rheumatoid nodules.

Mentions: Final pathology evaluation revealed a necrotizing granuloma, compatible with rheumatoid etiology (Figure 2). Stains for fungus and acid fast bacilli were negative. The patient was discharged from the hospital in stable condition and, at 6-month follow-up, had no significant sequelae. Her RA continued to require treatment with methotrexate.


Rheumatoid arthritis mimicking metastatic squamous cell carcinoma.

Gomez-Rivera F, El-Naggar AK, Guha-Thakurta N, Kupferman ME - Head Neck Oncol (2011)

Photomicroscopy. The lesion composed of multiple irregular, fairly demarcated nodules with central eosinophilic necrosis (×20) lined by thick peripheral layer of palisading mono-nuclear cells (inset ×40) characteristic of rheumatoid nodules.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3118955&req=5

Figure 2: Photomicroscopy. The lesion composed of multiple irregular, fairly demarcated nodules with central eosinophilic necrosis (×20) lined by thick peripheral layer of palisading mono-nuclear cells (inset ×40) characteristic of rheumatoid nodules.
Mentions: Final pathology evaluation revealed a necrotizing granuloma, compatible with rheumatoid etiology (Figure 2). Stains for fungus and acid fast bacilli were negative. The patient was discharged from the hospital in stable condition and, at 6-month follow-up, had no significant sequelae. Her RA continued to require treatment with methotrexate.

Bottom Line: Imaging demonstrated a 1.4 cm cystic lesion at the hyoid bone.A trans-cervical approach was used.Pathology revealed a necrotizing granuloma compatible with rheumatoid etiology.

View Article: PubMed Central - HTML - PubMed

Affiliation: Otorhinolaryngology - Head and Neck Surgery/Otolaryngology, The University of Houston Health Science Center, Houston, Texas, USA.

ABSTRACT
We report a case of a cervical rheumatoid nodule in close relation to the hyoid bone mimicking a metastatic carcinoma. A 74-year-old female with a 15-year history of rheumatoid arthritis (RA) on treatment with methotrexate presented with tenderness of the right base of tongue. Imaging demonstrated a 1.4 cm cystic lesion at the hyoid bone. Biopsies were unsuccessful and the patient required surgical resection of the mass. A trans-cervical approach was used. Pathology revealed a necrotizing granuloma compatible with rheumatoid etiology. The clinician should be aware that, in a patient with a neck mass, in the presence of active RA, rheumatoid nodules should be part of the differential diagnosis.

Show MeSH
Related in: MedlinePlus