VALUE OF SYNOVIAL-FLUID ANALYSIS IN MULTICENTRIC RETICULOHISTIOCYTOSIS - REPORT OF A CASE

The authors report the case of a patient who had both multicentric ret iculohistiocytosis - a systemic disease characterized by symmetric pol yarthritis and papulonodular skin lesions - and an ovarian adenocarcin oma. Synovial fluid analysis found histiocytes with a ground-glass cyt oplasm, binucleate giant cells, and undifferentiated cells undergoing mitosis. PAS-positive, diastase-resistant cells similar to the synovia l fluid histiocytes were seen in the synovial and cutaneous biopsy spe cimens. These findings established the diagnosis of multicentric retic ulohistiocytosis and suggested an underlying malignancy. Whether or no t multicentric reticulohistiocytosis is a paraneoplastic syndrome rema ins unsettled. However, our report provides evidence that synovial flu id analysis can be helpful not only for the early diagnosis of multice ntric reticulohistiocytosis but also for suggesting the presence of an underlying tumor, especially when arthritis is the presenting symptom .