HISTOPATHOLOGICAL ANALYSIS OF SIXTEEN SUBCUTANEOUS RHEUMATOID NODULES

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Abstract
An immunopathological study was carried out on subcutaneous nodules (rheumatoid nodules) biopsied from 16 patients with rheumatoid arthritis. Sixteen rheumatoid nodules were histologically classified into 3 stages: the 1st stage (acute inflammatory stage, 3 cases), the 2nd stage (granulomatous stage, 10 cases) and the 3rd stage (scar-formed stage, 3 cases). In necrotic or granulation tissue of the nodules in the 3 stages, immunofluorescent analysis using FITC[fluorescen-isothiocyanate]-labeled rabbit anti-human Ig, .beta.1C, and fibrinogen serum .gamma.-globulins and FITC-labeled aggregated human IgG gave results that were strongly positive in the 1st stage; moderately positive in the 2nd stage; and only slightly positive or almost negative in the 3rd stage. Acute or chronic thrombotic endoarteritis was observed around rheumatoid nodules in 6 of the 16 cases. Among them, 2 cases of the 1st stage showed acute thrombotic endoarteritis with marked infiltration of neutrophils in the wall, and 2 cases of the 2nd and the 3rd stages, respectively showed chronic endoarteritis with organized thrombi.