The Histopathology of Rheumatoid Episcleral Nodules

Abstract

ACCORDING to Duke-Elder and Leigh-Duke-Elder four types of episcleral or scleral inflammation can be firmly ascribed to the collagen diseases, and particularly to rheumatoid arthritis.¹These are rheumatoid episcleral nodules, necrotizing nodular scleritis, scleromalacia perforans, and massive granuloma of the sclera. Nodular episcleritis is relatively uncommon in the collagen diseases, occurring most frequently in rheumatoid arthritis.¹Only three cases of rheumatoid episcleral nodules studied histopathologically have been reported.^2-4These lesions are localized areas of granulomatous inflammation in which the histopathologic picture closely resembles that seen in subcutaneous rheumatoid nodules. The purpose of the present paper is to report the fourth case in which an rheumatoid episcleral nodule has been examined pathologically, and to emphasize the specific histopathologic pattern exhibited by these lesions. Report of a Case A 63-year-old white woman was admitted to the hospital complaining of pain in the joints, particularly in her shoulders. She had