Rheumatic nodules in Egyptian children.
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Rheumatic nodules occur in some 20 to 25% of cases of chronic polyarthritis, and need special diagnostic, in particular differential diagnostic, consideration. They have to be differentiated from numerous other nodules in rheumatoid and non-rheumatoid diseases. To achieve this, palpation, a knowledge of the preferred sites, and the use of such technical means as laboratory and x-ray investigations are all useful.
Aschoff nodules (ANs) in excised atrial appendages from cases of rheumatic heart disease were examined with a scanning electron microscope (SEM). ANs could be identified with ease as nodular, fairly well defined cell aggregates lying in the subendocardium closely apposed to the myocardium. Cells comprising ANs were loosely packed in stacks. They were rectangular, oblong and angulated. The surface of some cells had fine ribbing while others were smooth having occasional blunt projections. SEM observations coupled with the findings of conventional and electron microscopy suggest that cells composing ANs are of mesenchymal origin having characters of epithelioid cells, reticular cells and/or fibroblasts.
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