Multicentric reticulohistiocytosis: a case report

Abstract

Background: Multicentric reticulohistiocytosis is a rare form of non-langerhans cell histiocytosis presenting with skin changes and erosive arthritis. Infiltration of histiocytes and multinucleated giant cells are typical histological findings and confirm the diagnosis.

Case presentation: This case report describes a newly diagnosed case of multicentric reticulohistiocytosis in a healthy 26-year-old female originally from the Philippines. Eruption of papules and nodules on the hands and pain in multiple joints were the main complaints at the initial presentation. Radiographical findings of erosions in the small hand and feet joints were impressive. Initial histological findings did not match the clinical image, although later the clinical diagnosis was supported by histological findings in additional biopsies.

Conclusions: Although initial histological findings did not match the clinical image, additional biopsies were valuable to confirm the diagnosis.

Keywords: Histiocytosis; Multicentric reticulohistiocytosis; Non-langerhans cell histiocytosis.

Fig. 1

Firm nodules and papules (0.5–1.0 cm) on the hands at time of presentation

Fig. 2

Patches of grouped, flat, red/brown papules which arose after use of prednisone, 30 mg for 3 days

Fig. 3

Radiographs of the hands, showing impressive erosions and destruction of small joints

Fig. 4

Numerous large histiocytes with sharply delineated nuclear membranes and prominent nucleoli are scattered through the dermal collagen. In the center a multinucleate giant cell is present (hematoxylin and eosin, original magnification ×200). Most of the histiocytes stained positive for CD68, whereas immunostaining for CD1a (Langerhans cells) was negative (not shown)