Erdheim-Chester Disease: A Unique Presentation With Liver Involvement and Vertebral Osteolytic Lesions

Archives of Pathology and Laboratory Medicine - Tập 127 Số 8 - Trang e337-e339 - 2003
Doina Ivan1, Antonio Galvao Neto1, Luciano B. Lemos1, Arpan Gupta1
1From the Department of Pathology and Laboratory Medicine, University of Texas (Drs Ivan, Neto, and Lemos), and the Department of Radiology/Radiation Oncology, Baylor College of Medicine (Dr Gupta), Houston, Tex

Tóm tắt

Abstract Erdheim-Chester disease is a very rare xanthogranulomatous, non-Langerhans cell systemic histiocytosis with an unknown etiology and pathogenesis. Histologically, it is characterized by a diffuse infiltration with large, foamy histiocytes, rare Touton-like giant cells, lymphocytic aggregates, and fibrosis. The histiocytes differ from the Langerhans cell group in ontogenesis, immunohistochemistry (positive for CD68 and negative for CD1a and S100 protein), and ultrastructural appearance (lack of Birbeck granules). Although most of the cases have symmetric osteosclerosis of the long bones, an involvement of the axial skeleton has also been described. Extraskeletal lesions are present in more than 50% of the patients and may involve the retroperitoneal space, lungs, kidneys, brain, retro-orbital space, and heart. This study presents the case of a patient with Erdheim-Chester disease with vertebral destruction and, for the first time, to our knowledge, involvement of the liver. The diagnosis is based on radiologic, histologic, immunohistochemical, and ultrastructural findings.

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Tài liệu tham khảo

Chester, 1930, Uber lipoidgranulomatose., Virchows Arch Pathol Anat, 279, 561, 10.1007/BF01942684

Chartist, 1999, Chester-Erdheim disease: a neoplastic disorder., Hum Pathol, 30, 1093, 10.1016/S0046-8177(99)90228-9

Al-Quaran, 2002, Erdheim-Chester disease: a case report, PCR-based analysis of clonality, and review of literature., Mod Pathol, 15, 666, 10.1038/modpathol.3880583

Veyssier-Belot, 1996, Erdheim-Chester disease: clinical and radiologic characteristics of 59 cases., Medicine, 75, 157, 10.1097/00005792-199605000-00005

Kenn, 1999, Erdheim-Chester disease: a case report and literature overview., Eur Radiol, 9, 153, 10.1007/s003300050647

Klieger, 2002, Erdheim-Chester disease: a unique presentation with multiple osteolytic lesions of the spine and pelvis and spared the appendicular skeleton., AJR, 178, 429, 10.2214/ajr.178.2.1780429

Writing Group of the Histiocyte Society., 1987, Histiocytosis syndromes in children., Lancet, 1, 208

Kenn, 2000, Erdheim-Chester disease: evidence for a disease entity different from Langerhans cell histiocytosis? Three cases with detailed radiological and immunohistochemical analysis., Hum Pathol, 31, 734, 10.1053/hupa.2000.8229

Waite, 1988, Langerhans cell histocytosis with radiographic findings of Erdheim-Chester disease., AJR, 150, 869, 10.2214/ajr.150.4.869

Rush, 2000, Pulmonary pathology of Erdheim-Chester disease., Mod Pathol, 13, 747, 10.1038/modpathol.3880130

Mascalchi, 2002, Failure of radiation therapy for brain involvement in Erdheim-Chester disease., J Neurooncol, 59, 169, 10.1023/A:1019649201324