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Pathology
50-year-old, presents with enlarged knuckles and large subcutaneous nodules near her elbows. Her proximal interphalangeal (PIP) joints are hyperextended and her distal interphalangeal (DIP) joints are flexed. If the nodules were biopsied, which of the following would best describe their likely histological appearance?
Amorphous crystalline mass surrounded by macrophages
Cystic space caused by myxoid degeneration of connective tissue
Darkly pigmented synovium with an exuberant, villous growth
Fibrinoid necrosis surrounded by palisading epithelioid cells
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