MORPHOLOGICAL AND HISTOCHEMICAL-CHANGES OF THE SYNOVIAL-MEMBRANE IN EARLY RHEUMATOID-ARTHRITIS - HISTOLOGICAL STUDIES

  • 1 January 1980
    • journal article
    • research article
    • Vol. 39  (1-2) , 33-45
Abstract
Histological and histochemical findings in synovial membranes of 13 patients with early rheumatoid arthritis [RA] (duration not more than 6 mo.; clinical follow-up at least 2 yr) were compared to 16 late cases of definite RA (ARA [American Rheumatologic Association] criteria). Dynamic evolution of rheumatoid synovitis was investigated and full-fledged changes were analyzed with reference to diagnosis and pathogenesis of RA. Although the basic pattern of reaction is the same, the following peculiarities are found in early RA: a band-like mucoid swelling of the synovial adventitia, histochemically with increase of acid glucosaminoglycans; more frequent occurrence of vasculitis; less marked infiltration with lymphocytes and plasma cells; absence of gross fibrin inudation and granulocyte infiltration; absence of diffuse fibrosis and hyalinosis. For diagnostic purposes, it is important that proliferative reactions can be found but are much less marked than in late cases. Early morphological findings do not allow more than the suspicion of RA. Combined mucoid swelling of the ground substance and vasculitis together with further signs of proliferation and exudation are most important. Frequent vasculitic changes and early occurrence of immuno-competent cells, which are the cytological condition of immunological reactions, are important in RA pathogenesis.