TY - JOUR
T1 - Reactive granular histiocytosis secondary to arthroplasty prosthesis
T2 - A novel reaction pattern
AU - Miller, Daniel D.
AU - Yaar, Ron
AU - Posnik, Oksana
AU - Karolow, Wayne
AU - Mahalingam, Meera
PY - 2012/5/1
Y1 - 2012/5/1
N2 - A reactive histiocytic infiltrate can be seen as an incidental finding in a lymph node biopsy from a patient with a history of joint arthroplasty. We report the case of a 74-year-old female who underwent surgical revision of a polyethylene-based right total knee prosthesis due to chronic wear. At the time of surgery, a soft tissue mass adjacent to the tibial prosthetic insert was noted and excised. Histopathologic examination revealed a sheet-like proliferation of large, histiocytoid cells within the subcutis and superficial fascia. The cells showed abundant eosinophilic, granular cytoplasm and small round bland nuclei. Immunohistochemical evaluation revealed the cells to be positive only for CD68. In addition, abundant PAS-positive cytoplasmic granules were found, and minute particles of polarizable material were noted intracellularly and scattered throughout the interstitium of the infiltrate. These findings were interpreted as consistent with a reactive, non-Langerhans cell histiocytosis secondary to the patient's polyethylene knee prosthesis. This finding appears to be a local correlate of the process previously described in regional lymph nodes as reactive granular histiocytosis. Dermatopathologists should be cognizant of this uncommon reaction pattern to avoid mistaking it for a neoplastic process. Miller DD, Yaar R, Posnik O, Karolow W, Mahalingam M. Reactive granular histiocytosis secondary to arthroplasty prosthesis: a novel reaction pattern.
AB - A reactive histiocytic infiltrate can be seen as an incidental finding in a lymph node biopsy from a patient with a history of joint arthroplasty. We report the case of a 74-year-old female who underwent surgical revision of a polyethylene-based right total knee prosthesis due to chronic wear. At the time of surgery, a soft tissue mass adjacent to the tibial prosthetic insert was noted and excised. Histopathologic examination revealed a sheet-like proliferation of large, histiocytoid cells within the subcutis and superficial fascia. The cells showed abundant eosinophilic, granular cytoplasm and small round bland nuclei. Immunohistochemical evaluation revealed the cells to be positive only for CD68. In addition, abundant PAS-positive cytoplasmic granules were found, and minute particles of polarizable material were noted intracellularly and scattered throughout the interstitium of the infiltrate. These findings were interpreted as consistent with a reactive, non-Langerhans cell histiocytosis secondary to the patient's polyethylene knee prosthesis. This finding appears to be a local correlate of the process previously described in regional lymph nodes as reactive granular histiocytosis. Dermatopathologists should be cognizant of this uncommon reaction pattern to avoid mistaking it for a neoplastic process. Miller DD, Yaar R, Posnik O, Karolow W, Mahalingam M. Reactive granular histiocytosis secondary to arthroplasty prosthesis: a novel reaction pattern.
KW - arthroplasty
KW - granular cell
KW - histiocytosis
KW - oncocytic
KW - polyethylene
UR - http://www.scopus.com/inward/record.url?scp=84860171471&partnerID=8YFLogxK
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U2 - 10.1111/j.1600-0560.2012.01892.x
DO - 10.1111/j.1600-0560.2012.01892.x
M3 - Review article
C2 - 22515227
AN - SCOPUS:84860171471
VL - 39
SP - 558
EP - 561
JO - Journal of Cutaneous Pathology
JF - Journal of Cutaneous Pathology
SN - 0303-6987
IS - 5
ER -