Eosinophilic granuloma of spine in adults: a report of 30 cases and outcome

Huang, Wending; Yang, Xinghai; Cao, Dong; Xiao, Jianru; Yang, Mosong; Ding, Feng; Huang, Quan; Wu, Zhipeng; Zheng, Wei; Jia, Lianshun; Wu, Shujia

doi:10.1007/s00701-010-0644-3

Cited by 38 publications

(56 citation statements)

References 37 publications

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“…CT and MRI of osteoblastomas may show a shell of reactive periosteal bone and edema and atrophy of surrounding soft tissues. Although it is difficult to rule out osteoblastoma on our patient's clinical imaging, osteoblastoma is histologically composed of woven bone with prominent osteoblastic rimming, separated by loose fibrovascular stroma [15]; in contrast, our patient exhibited predominant fibrous proliferation with focal bone formation without prominent osteoblastic rimming. Although our patient's imaging studies showed no malignant features of bony destruction or aggressive periosteal reaction, a low-grade osteosarcoma was in the differential diagnosis.…”

Section: Discussion and Treatmentmentioning

confidence: 81%

“…Radiographically, lytic lesions often are seen, with or without a sclerotic rim. Vertebra plana is seen occasionally on plain films [15], and sheets of Langerhans cells with an inflammatory infiltrate including eosinophils, histiocytes, and giant cells are seen histologically, which were not present in our patient [20]. Giant cell tumors of the spine occur predominantly in the sacrum, but they can be found in the lumbar spine [22].…”

Section: Discussion and Treatmentmentioning

confidence: 99%

“…Langerhans cell histiocytosis is a benign proliferation of histiocytes mostly seen in patients younger than 20 years [2]. Langerhans cell histiocytosis affects the spine in 6.5% of cases, predominantly the cervical spine, and more commonly in the vertebral body [15]. Radiographically, lytic lesions often are seen, with or without a sclerotic rim.…”

Section: Discussion and Treatmentmentioning

confidence: 99%

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A 33-year-old Man With Low Back Pain

Zhang

Hess

Nielsen

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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A 33-year-old man was evaluated in the clinic for a 9-month history of low back pain. The pain was dull and low grade, worse with activity, occasionally waking him at night. He had no history of antecedent trauma. He had no radiation of pain, focal neurologic symptoms, balance difficulties, or difficulties with fine motor tasks. He had tried aspirin with variable relief, and acupuncture and chiropractic care with no significant improvement. He had no medical conditions, never had spine surgery, and never smoked. He exercised daily doing weight lifting and martial arts, with which his back pain interfered.On physical examination, the patient was generally healthy and appeared well. He had midline tenderness to palpation in his midlumbar spine. The patient had normal strength and ROM, and sensation was intact to light touch throughout. He had normal deep tendon reflexes and no long tract signs. He had normal gait and station.AP and lateral plain films (Fig. 1) of the lumbar spine were obtained initially, followed by CT (Fig. 2) and MRI (Fig. 3); the latter tests were ordered owing to the findings we observed on the plain radiographs.

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Section: Discussion and Treatmentmentioning

confidence: 81%

Section: Discussion and Treatmentmentioning

confidence: 99%

Section: Discussion and Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

A 33-year-old Man With Low Back Pain

Zhang

Hess

Nielsen

et al. 2014

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

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“…As the disease is self-limiting, surgical intervention is not always recommended. Chemotherapy is recommended for multiple lesions 2,5 , but the benefits of radiotherapy are still under debate [1][2]5 . Simultaneous involvement of the thyroid, pituitary, and parathyroid glands has been reported, sometimes in association with diabetes insipidus 3 .…”

Section: Discussionmentioning

confidence: 99%

Langerhans Cell Histiocytosis with Extensive Spinal and Thyroid Gland Involvement Presenting with Quadriparesis: An Unusual Case in an Adult Patient

Soh¹

2011

MOJ

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Langerhans cell histiocytosis of the spine frequently presents as a solitary lesion and rarely results in neurological deficit. Involvement of thyroid tissue is also rare, even in multifocal disease presentations. We present an unusual variant of Langerhans cell histiocytosis in a 37-year-old man presenting with profound quadriparesis and incidental thyroid involvement. MR imaging and skeletal radiographs revealed widespread involvement of the spine. The patient underwent surgical resection of the tumour and stabilization of the spine. Diagnosis was confirmed by histological and immunohistochemistry analysis.Langerhans cell histiocytosis should be included in the differential diagnosis of radiolucent lesions of the spine in adults.

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“…In the spine, LCH mainly involves the vertebral bodies, with a predilection for the thoracic spine (54 %) followed by the lumbar (35 %) and cervical spine (11 %) (Abu-Bonsrah et al 2016). Only a small number of cases of LCH in the adult lumbar spine have been reported in the English literature (Huang et al 2010; Demirci 2004; Bavbek et al 2004; Bilge et al 1995). This article describes the case of 35-year-old man diagnosed with LCH presenting as an osteolytic lesion of the L1 vertebral body.…”

Section: Introductionmentioning

confidence: 99%

Langerhans cell histiocytosis in the adult lumbar spine: case report

et al. 2016

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IntroductionLangerhans cell histiocytosis (LCH) occurs rarely in the spine of adults. The radiological findings usually resemble vertebral tumors. Etiology of LCH has not been clearly established yet. Therapeutic approaches are still controversial. We describe a case of LCH in an adult spine.Case descriptionA patient who presented with low back pain had an osteolytic lesion in the L1 vertebral body without neurological deficits, and fluoroscopy-guided needle biopsy of the L1 vertebral body was performed. The immunohistochemical diagnosis confirmed LCH. The patient was successfully treated with conservative methods.DiscussionThe choice of appropriate therapy is very important, with treatment options varying from watch-and to aggressive treatment.ConclusionLCH is considered as a pediatric disease that is extremely rare in the spine of adults and should be include in the differential diagnosis of osteolytic vertebral lesions. Conservative treatment is best choice for a patient with LCH without neurological deficit or spinal instability.

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Eosinophilic granuloma of spine in adults: a report of 30 cases and outcome

Cited by 38 publications

References 37 publications

A 33-year-old Man With Low Back Pain

A 33-year-old Man With Low Back Pain

Langerhans Cell Histiocytosis with Extensive Spinal and Thyroid Gland Involvement Presenting with Quadriparesis: An Unusual Case in an Adult Patient

Langerhans cell histiocytosis in the adult lumbar spine: case report

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