7 월달 weekly case

Tae Yong Moon, M.D.Pusan National University Hospital

• Age/Sex : 27 year-old male• CC : Left radiating pain for 2 months

T1 T2FS T1-Gd DTPA FS

T1-Gd DTPA FS T1

• Radiological impression of Lumbar and hip MR before excisional biopsy ; hematologic disorder such as leukemia, lymphoma, multiple myeloma

• Radiological impression of lung CT before biopsy ; active cavitary pulmonary tuberculosis

Pathological Diagnosis

• Langerhans’ cell histiocytosis (LCH) by excisional iliac bone biopsy

• Langerhans’ cell histiocytosis (LCH) by lung biopsy

Discussion

• LCH of bone is a disorder of histiocytic proliferation with variable and often unpredictable behavior.

• Ranged from 3 months to 50 years old (mean, 12 years; median, 10 years) in 245 patients by Mayo Clinic.

• The skull was the most frequent osseous site.• Diabetes insipidus was documented in 12% of th

e patients.

References• Kilpatrick SE, Wenger DE, et al. Langerhans’ cell histiocyt

osis (histiocytosis X) of bone. A clinicopathologic analysis of 263 pediatric and adult cases. Cancer 1995; 76:2471-84

• Baillet A, Grange L, Lafaix PA, Gaudin P, Juvin R. Radiculopathy as a manifestation of Langerhans’ cell histiocytosis. Joint Bone Spine 2007; 74: 190-3

• Hamre M, Hedberg J, Buckley J, et al. Langerhans cell histiocytosis: an exploratory epidemiologic study of 177 cases. Med Pediatr Oncol 1997; 28: 92-7

• Dacic S, Trusky C, Bakker A, et al. Genotypic analysis of pulmonary Langerhans cell histiocytosis. Hum Pathol 2003; 34: 1345-9