Share This Article:

Intralymphatic Histiocytosis with Rheumatoid Arthritis: Possible Association with the Joint Involvement

Abstract Full-Text HTML XML Download Download as PDF (Size:483KB) PP. 149-152
DOI: 10.4236/crcm.2014.33036    3,093 Downloads   4,173 Views   Citations

ABSTRACT

Intralymphatic histiocytosis is characterized by dilated vessels containing aggregates of mononuclear histiocytes in their lumina, and the majority of cases have been associated with rheumatoid arthritis (RA). We report a case of a 61-year-old woman with RA who presented with livedo-like erythema and red papules around the right elbow and forearm. Histological examinations demonstrated numerous dilated vessels in the dermis partially filled with medium- to large-sized mononuclear cells. Immunohistochemically, most of the intraluminal cells were CD68-positive histiocytes. Endothelial cells were positive for D2-40, a marker for lymphatic endothelial cells. We diagnosed the patient with intralymphatic histiocytosis based on these clinical and histological findings. Interestingly, the skin manifestations exacerbated during the course of the disease when the swelling of the patient’s right elbow joint progressed. Then, the puncture of content fluid of the joint was performed, since then, the symptoms of the skin lesion immediately improved. These observations suggest a possible association between the eruptions of intralymphatic histiocytosis and the involved joint. The results suggest that such skin eruptions may be ameliorated by treating severe arthritis.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Kaneko, T. , Takeuchi, S. , Nakano, H. and Sawamura, D. (2014) Intralymphatic Histiocytosis with Rheumatoid Arthritis: Possible Association with the Joint Involvement. Case Reports in Clinical Medicine, 3, 149-152. doi: 10.4236/crcm.2014.33036.

References

[1] O’Grady, J.T., Shahidullah, H., Doherty, V.R. and Al-Nafussi, A. (1994) Intravascular Histiocytosis. Histopathology, 24, 265-268. http://dx.doi.org/10.1111/j.1365-2559.1994.tb00519.x
[2] Prium, B., Strutton, G., Congton, S., Whitehead, K. and Donaldson, E. (2000) Cutaneous Histiocytic Lymphangitis: An Unusual Manifestation of Rheumatoid Arthritis. Australasian Journal of Dermatology, 41, 101-105.
http://dx.doi.org/10.1046/j.1440-0960.2000.00404.x
[3] Catalina-Fernández, I., Alvárez, A.C., Martin, F.C., Fernández-Mera, J.J. and Sánez-Santamaria, J. (2007) Cutaneous Intralymphatic Histiocytosis Associated with Rheumatoid Arthritis: Report of a Case and Review of the Literature. American Journal of Dermatopathology, 29, 165-168. http://dx.doi.org/10.1097/01.dad.0000251824.09384.46
[4] Watanabe, T., Yamada, N., Yoshida, Y. and Yamamoto, O. (2008) Intralymphatic Histiocytosis with Granuloma Formation Associated with Orthopaedic Metal Implants. British Journal of Dermatology, 158, 402-404.
http://dx.doi.org/10.1111/j.1365-2133.2007.08295.x
[5] De Unamuno Bustos, B., García Rabasco, A., Ballester Sánchez, R., Martinez Aparicio, A. and Alegre de Miquel, V. (2013) Erythematous Indurated Plaque on the Right Upper Limb. Intralymphatichistiocytosis (IH) Associated with Orthopedic Metal Implant. International Journal of Dermatology, 52, 547-549.
http://dx.doi.org/10.1111/j.1365-4632.2012.05696.x
[6] Echeverría-García, B., Botella-Estrada, R., Requena, C. and Guillén, C. (2010) Intralymphatic Histiocytosis and Cancer of the Colon. Actas Dermo-Sifiliográficas (English Edition), 101, 257-262.
http://dx.doi.org/10.1016/S1578-2190(10)70625-9
[7] Okazaki, A., Asada, H., Niizeki, H., Nonomura, A. and Miyagawa, S. (2005) Intravascular Histiocytosis Associated with Rheumatoid Arthritis: Report of a Case with Lymphatic Endothelial Proliferation. British Journal of Dermatology, 152, 1385-1387. http://dx.doi.org/10.1111/j.1365-2133.2005.06618.x
[8] Rieger, E.,Soyer, H.P., Leboit, P.E., Metze, D., Slovak, R. and Kerl, H. (1999) Reactive angioendotheliomatosis or Intravascular Histiocytosis? An Immunohistochemical and Ultrastructual Study in Two Cases of Intravascular Histiocytic Cell Proliferation. British Journal of Dermatology, 140, 497-504.
http://dx.doi.org/10.1046/j.1365-2133.1999.02717.x
[9] Requena, L., El-Shabrawi-Caelen, L., Walsh, S.N., Sequra, S., Ziemer, M., Hurt, M.A., Sangüezaet, O.P. and Kutzner, H. (2009) Intralymphatic Histiocytosis. A Clinicopathologic Study of 16 Cases. American Journal of Dermatopathology, 31, 140-151. http://dx.doi.org/10.1097/DAD.0b013e3181986cc2
[10] Grekin, S., Mesfin, M., Kang S. and Fullen, D.R. (2011) Intralymphatic Histiocytosis Following Placement of a Metal Implant. Journal of Cutaneous Pathology, 38, 351-153. http://dx.doi.org/10.1111/j.1600-0560.2010.01556.x
[11] Takiwaki, H., Adachi, A., Kohno, H. and Ogawa, Y. (2004) Intravascular or Intralymphatic Histiocytosis Associated with Rheumatoid Arthritis: A Report of 4 Cases. Journal of the American Academy of Dermatology, 50, 585-590.
http://dx.doi.org/10.1016/j.jaad.2003.09.025

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.