Rice bodies in nontuberculous mycobacterial tenosynovitis of the wrist joint.
Itaru Ogawa, Takuya Kameda, Chiharu Nagashima et al.
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Case in brief
An 89-year-old female farmer presented with a recurrent mass in her right forearm after two excisions. MRI showed low-intensity areas, and surgery revealed rice bodies. Histopathology demonstrated an epithelioid granuloma; the anti-GPL-core IgA antibody test was negative. Culture of excised tissue identified Mycobacterium intracellulare, confirming nontuberculous mycobacterial tenosynovitis. She received antituberculous agents, with no recurrence at one-year follow-up.
What made this case unusual
The recurrent forearm mass contained rice bodies, while tissue culture—not the negative anti-GPL-core IgA test—established Mycobacterium intracellulare as the cause.
Diagnostic / clinical pearl
For suspected NTM tenosynovitis, combine imaging and operative findings with microbiological testing of tissue; nonspecific symptoms and a negative antibody test may not establish the diagnosis.