Top

Journal of Orthopaedic Surgery and Research

Published in:

Open Access 01-12-2019 | Langerhans Cell Histiocytosis | Research article

Incidence and radiological pattern of eosinophilic granuloma: a retrospective study in a Chinese tertiary hospital

Authors: Sha-Sha Zhao, Lin-Feng Yan, Xiu-Long Feng, Pang Du, Bao-Ying Chen, Wen-Ting Dong, Yi Gao, Jie-Bing He, Guang-Bin Cui, Wen Wang

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2019

Abstract

Background

The incidence and radiological patterns of eosinophilic granuloma (EG) in China is not clear. We described the incidence, presentation, and imaging characteristics of Chinese EG patients in a tertiary hospital.

Methods

A retrospective chart review was performed from January 2004 to October 2017 at a single tertiary general hospital. Seventy-six patients were pathologically identified as EG. Besides, 60 patients with preoperative imaging diagnosis of “EG” were analyzed to reveal the radiological patterns and their diagnostic power.

Results

Fifty-three male and 23 female EG patients with a mean age of 18.1 ± 16.7 years (range 1–58 years) were retrospectively included. Significant differences were observed in gender (male to female = 2.3:1) and age (the highest incidence at the age of 0~5 years) for EG. EG predominantly involved the skeletal system: flat bones (31.43%) > irregular bones (24.76%) > long bones (22.86%) > other organs (20.95%). No obvious relationships between season, biochemical markers, and EG incidence were observed. The common presenting symptoms were pain followed with local mass, and most patients underwent surgical resection. Among 60 imagingly diagnosed “EG” patients from April 2009 to October 2017, only 22 were with histological confirmation. The correct diagnosis rates were 37.1% (13 out of 35), 16.7% (5 out of 30), and 22.2% (8 out of 36) for plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI), respectively.

Conclusions

Chinese EG has a varied presentation, age distribution, and gender difference. EG diagnosis is still based on biopsy or histopathology instead of imaging techniques.

Available only for authorised users

Mitchell JM, Berzins SP, Kannourakis G. A potentially important role for T cells and regulatory T cells in Langerhans cell histiocytosis. Clin Immunol. 2018;194:19–25. https://doi.org/10.1016/j.clim.2018.06.004.CrossRefPubMed

Haupt R, Minkov M, Astigarraga I, et al. Langerhans cell histiocytosis (LCH): guidelines for diagnosis, clinical work-up, and treatment for patients till the age of 18 years. Pediatr Blood Cancer. 2013;60(2):175–84. https://doi.org/10.1002/pbc.24367.CrossRefPubMed

Zheng W, Wu J, Wu Z, Xiao J. Atlantoaxial instability secondary to eosinophilic granuloma of the axis in adults: long-term follow-up in six cases. Spine J. 2014;14(11):2701–9. https://doi.org/10.1016/j.spinee.2014.03.013.CrossRefPubMed

Emile JF, Abla O, Fraitag S, et al. Revised classification of histiocytoses and neoplasms of the macrophage-dendritic cell lineages. Blood. 2016;127(22):2672–81. https://doi.org/10.1182/blood-2016-01-690636.CrossRefPubMedPubMedCentral

Stalemark H, Laurencikas E, Karis J, Gavhed D, Fadeel B, Henter JI. Incidence of Langerhans cell histiocytosis in children: a population-based study. Pediatr Blood Cancer. 2008;51(1):76–81. https://doi.org/10.1002/pbc.21504.CrossRefPubMed

Bertram C, Madert J, Eggers C. Eosinophilic granuloma of the cervical spine. Spine (Phila Pa 1976). 2002;27(13):1408–13.CrossRef

Huang WD, Yang XH, Wu ZP, et al. Langerhans cell histiocytosis of spine: a comparative study of clinical, imaging features, and diagnosis in children, adolescents, and adults. Spine J. 2013;13(9):1108–17. https://doi.org/10.1016/j.spinee.2013.03.013.CrossRefPubMed

Drevelegas A, Chourmouzi D, Boulogianni G, Sofroniadis I. Imaging of primary bone tumors of the spine. Eur Radiol. 2003;13(8):1859–71. https://doi.org/10.1007/s00330-002-1581-1.CrossRefPubMed

Zhang X, Zhou J, Chai X, et al. The application of x-ray, computed tomography, and magnetic resonance imaging on 22 pediatric Langerhans cell histiocytosis patients with long bone involvement: A retrospective analysis. Medicine (Baltimore). 2018;97(17):e0411. https://doi.org/10.1097/MD.0000000000010411.CrossRefPubMedPubMedCentral

10.

Rizzo FM, Cives M, Simone V, Silvestris F. New insights into the molecular pathogenesis of langerhans cell histiocytosis. Oncologist. 2014;19(2):151–63. https://doi.org/10.1634/theoncologist.2013-0341.CrossRefPubMedPubMedCentral

11.

Abdel-Aziz M, Rashed M, Khalifa B, Talaat A, Nassar A. Eosinophilic granuloma of the temporal bone in children. J Craniofac Surg. 2014;25(3):1076–8. https://doi.org/10.1097/SCS.0000000000000468.CrossRefPubMed

12.

Inci MF, Inci R, Ozkan F. Multidetector CT findings of calvarial eosinophilic granuloma. BMJ Case Rep. 2013;2013. https://doi.org/10.1136/bcr-2013-009698.

13.

Arkader A, Glotzbecker M, Hosalkar HS, Dormans JP. Primary musculoskeletal Langerhans cell histiocytosis in children: an analysis for a 3-decade period. J Pediatr Orthop. 2009;29(2):201–7. https://doi.org/10.1097/BPO.0b013e3181982aa2.CrossRefPubMed

14.

Hashmi MA, Haque N, Chatterjee A, Guha S. Langerhans cell histiocytosis of long bones: MR imaging and complete follow up study. J Cancer Res Ther. 2012;8(2):286–8. https://doi.org/10.4103/0973-1482.98991.CrossRefPubMed

15.

Postini AM, Andreacchio A, Boffano M, Pagano M, Brach Del Prever A, Fagioli F. Langerhans cell histiocytosis of bone in children: a long-term retrospective study. J Pediatr Orthop B. 2012;21(5):457–62. https://doi.org/10.1097/BPB.0b013e32835367c0.CrossRefPubMed

16.

Chow TW, Leung WK, Cheng FWT, et al. Late outcomes in children with Langerhans cell histiocytosis. Arch Dis Child. 2017;102(9):830–5. https://doi.org/10.1136/archdischild-2016-312185.CrossRefPubMed

17.

Gao YJ, Su M, Tang JY, Pan C, Chen J. Treatment Outcome of Children With Multisystem Langerhans Cell Histiocytosis: The Experience of a Single Children’s Hospital in Shanghai, China. J Pediatr Hematol Oncol. 2018;40(1):e9–e12. https://doi.org/10.1097/MPH.0000000000001016.CrossRefPubMed

18.

Asilsoy S, Yazici N, Demir S, Erbay A, Kocer E, Sarialioglu F. A different cause for respiratory disorder in children: cases with pulmonary Langerhans cell histiocytosis. Clin Respir J. 2017;11(2):193–9. https://doi.org/10.1111/crj.12324.CrossRefPubMed

19.

Yagci B, Varan A, Caglar M, et al. Langerhans cell histiocytosis: retrospective analysis of 217 cases in a single center. Pediatr Hematol Oncol. 2008;25(5):399–408. https://doi.org/10.1080/08880010802107356.CrossRefPubMed

20.

Saliba I, Sidani K, El Fata F, Arcand P, Quintal MC, Abela A. Langerhans’ cell histiocytosis of the temporal bone in children. Int J Pediatr Otorhinolaryngol. 2008;72(6):775–86. https://doi.org/10.1016/j.ijporl.2008.02.001.CrossRefPubMed

21.

Ribeiro KB, Degar B, Antoneli CB, Rollins B, Rodriguez-Galindo C. Ethnicity, race, and socioeconomic status influence incidence of Langerhans cell histiocytosis. Pediatr Blood Cancer. 2015;62(6):982–7. https://doi.org/10.1002/pbc.25404.CrossRefPubMed

22.

Alston RD, Tatevossian RG, McNally RJ, Kelsey A, Birch JM, Eden TO. Incidence and survival of childhood Langerhans cell histiocytosis in Northwest England from 1954 to 1998. Pediatr Blood Cancer. 2007;48(5):555–60. https://doi.org/10.1002/pbc.20884.CrossRefPubMed

23.

Muller J, Garami M, Hauser P, et al. Hungarian experience with Langerhans cell histiocytosis in childhood. Pediatr Hematol Oncol. 2006;23(2):135–42. https://doi.org/10.1080/08880010500457988.CrossRefPubMed

24.

Chen RL, Lin KS, Chang WH, et al. Childhood Langerhans cell histiocytosis increased during El Nino 1997-98: a report from the Taiwan Pediatric Oncology Group. Acta Paediatr Taiwan. 2003;44(1):14–20.PubMed

25.

Xu X, Han S, Jiang L, et al. Clinical features and treatment outcomes of Langerhans cell histiocytosis of the spine. Spine J. 2018;18(10):1755–62. https://doi.org/10.1016/j.spinee.2018.02.025.CrossRefPubMed

26.

Wang D, Cui L, Li ZG, et al. Clinical research of pulmonary langerhans cell histiocytosis in children. Chin Med J (Engl). 2018;131(15):1793–8. https://doi.org/10.4103/0366-6999.237400.CrossRefPubMedPubMedCentral

27.

Zhu H, Ma Y, Sun L, Zhang R, Lv L, Wang A. Langerhans cell histiocytosis with lymph node involvement presenting as erythroderma. Acta Derm Venereol. 2019;99(1):99–100. https://doi.org/10.2340/00015555-3030.CrossRefPubMed

28.

Su M, Gao YJ, Pan C, Chen J, Tang JY. Outcome of children with Langerhans cell histiocytosis and single-system involvement: A retrospective study at a single center in Shanghai, China. Pediatr Hematol Oncol. 2019;(1–8). https://doi.org/10.1080/08880018.2018.1545814.CrossRef

Title: Incidence and radiological pattern of eosinophilic granuloma: a retrospective study in a Chinese tertiary hospital
Authors: Sha-Sha Zhao
Lin-Feng Yan
Xiu-Long Feng
Pang Du
Bao-Ying Chen
Wen-Ting Dong
Yi Gao
Jie-Bing He
Guang-Bin Cui
Wen Wang
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Langerhans Cell Histiocytosis
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Computed Tomography
Computed Tomography
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2019
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-019-1158-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Incidence and radiological pattern of eosinophilic granuloma: a retrospective study in a Chinese tertiary hospital

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2019

PI3K/Akt inhibitor partly decreases TNF-α-induced activation of fibroblast-like synoviocytes in osteoarthritis

Managing of post-traumatic knee arthritis by total knee arthroplasty: case series of 15 patients and literature review

Transferrin receptor-1 and VEGF are prognostic factors for osteosarcoma

Free vascularized iliac bone flap based on deep circumflex iliac vessels graft for the treatment of osteonecrosis of femoral head

Functional outcome of surgical treatment of adults with extremity osteosarcoma after megaprosthetic reconstruction—single-center experience

A second puncture and injection technique for treating osteoporotic vertebral compression fractures