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Pudis M, Palomar-Muñoz A, Solanich-Moreno X, Robles-Barba JJ, Rocamora-Blanch G, Rodríguez-Bel L, Narváez JA, Cortés-Romera M. The role of 2-[ 18F]FDG PET/CT in Erdheim-Chester disease. Rev Esp Med Nucl Imagen Mol 2024; 43:14-22. [PMID: 37804884 DOI: 10.1016/j.remnie.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/26/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVE To analyze the body distribution of Erdheim-Chester disease (ECD) and determine the utility of 2-[18 F]FDG PET/CT compared to other imaging techniques. Additionally, to assess the aggressiveness and extent of the disease based on the presence/absence of the BRAFV600E mutation. MATERIALS AND METHODS The 2-[18F]FDG-PET/CT scans of all patients diagnosed with ECD between 2008 and 2021 were reviewed, including 19 patients. The affected territories were classified as detectable by PET/CT or detectable only by other imaging techniques (bone scintigraphy, contrast-enhanced CT, or MRI). Descriptive analysis and correlation of the BRAF mutation with the affected organs and maximum SUV were performed using the Student's t-test. RESULTS Out of the 19 patients (14 males; mean age 60.3 years), 11 had the BRAFV600E mutation. A total of 127 territories (64 organ-systems) affected were identified using different imaging modalities, of which 112 were detected by PET/CT, and an additional 15 territories were solely identified by cerebral and cardiac MRI. The presence of BRAFV600E mutation was associated with greater organ involvement (p < 0.05) without differences in SUVmax (p > 0.05). CONCLUSION 2-[18F]FDG PET/CT is a highly effective diagnostic tool in patients with ECD, detecting the majority of affected territories. MRI was the only imaging modality with additional findings in territories showing high physiological uptake of 2-[18F]FDG (cerebral and cardiac). The presence of the BRAFV600E mutation correlated with a higher extent of the disease.
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Affiliation(s)
- M Pudis
- Servicio de Medicina Nuclear-PET(IDI), Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - A Palomar-Muñoz
- Servicio de Medicina Nuclear-PET(IDI), Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - X Solanich-Moreno
- Servicio de Medicina Interna, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - J J Robles-Barba
- Servicio de Medicina Nuclear-PET(IDI), Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - G Rocamora-Blanch
- Servicio de Medicina Interna, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - L Rodríguez-Bel
- Servicio de Medicina Nuclear-PET(IDI), Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - J A Narváez
- Servicio de Radiodiagnóstico, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M Cortés-Romera
- Servicio de Medicina Nuclear-PET(IDI), Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
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2
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Romano G, Cirillo M, Bonavita S, Toro G, Di Pietro A, Lavorgna L, Maida E, Pagliuca F, Urraro F, Coppola C, Lus G, Signoriello E. Apparently isolated CNS involvement in Erdheim-Chester disease: Case report. Radiol Case Rep 2023; 18:4431-4434. [PMID: 37840893 PMCID: PMC10570539 DOI: 10.1016/j.radcr.2023.09.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 08/28/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
We present the case of a 48-year-old-woman with apparently isolated central nervous system Erdheim-Chester disease characterized by brainstem involvement. Erdheim-Chester disease is extremely rare and multisystem impairment should always be sought in the suspicion of such pathology.
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Affiliation(s)
- Giuseppe Romano
- Second Division of Neurology, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Mario Cirillo
- MRI Research Center SUN-FISM, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Simona Bonavita
- Second Division of Neurology, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Andrea Di Pietro
- Second Division of Neurology, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Luigi Lavorgna
- First Division of Neurology, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Elisabetta Maida
- Second Division of Neurology, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Francesca Pagliuca
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, “Luigi Vanvitelli”, Naples, Italy
| | - Fabrizio Urraro
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Cinzia Coppola
- Second Division of Neurology, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giacomo Lus
- Second Division of Neurology, University of Campania “Luigi Vanvitelli”, Naples, Italy
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3
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Drouillard M, Trunet S, Hervochon R, Azoulay LD, Amoura Z, Cohen-Aubart F, Emile JF, Tankéré F, Haroche J. Sinonasal and ear manifestations of Erdheim-Chester disease. Br J Haematol 2023; 203:194-201. [PMID: 37394840 DOI: 10.1111/bjh.18963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/12/2023] [Accepted: 06/12/2023] [Indexed: 07/04/2023]
Abstract
To calculate the prevalence of sinonasal and ear involvement in an Erdheim-Chester disease (ECD) population, to describe the different ear, nose and throat (ENT) manifestations and to study the association between ENT involvement, other organ involvement, and BRAF mutations. We led a retrospective monocentric study in the national referral center for ECD. One hundred and sixty-two patients with ECD and ENT data were included between January 1, 1980 and December 31, 2020. Ear and nose clinical and radiological findings were noted. We described and studied the prevalence of ENT involvement in ECD population. The association between sinonasal and ear involvement, other organ involvement, and BRAF mutations was calculated. The prevalence of ENT manifestations is around 45%. No clinical rhinologic or otologic signs were specific to ECD. Sinus imaging was abnormal in 70% of cases. A bilateral maxillary sinus frame osteosclerosis was highly specific of ECD. Associations were found between the sinus MRI imaging type and BRAF status, central nervous system involvement, cerebellum involvement and xanthelasma. Sinonasal or ear involvement is frequent in ECD and has specific imaging features for sinuses. Trial registration: #2011-A00447-34.
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Affiliation(s)
- Mylène Drouillard
- ENT Department, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
| | - Stéphanie Trunet
- Neuroradiology Department, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
| | - Rémi Hervochon
- ENT Department, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
| | - Levi-Dan Azoulay
- Department of Internal Medicine 2, National Reference Center for Histiocytosis, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
| | - Zahir Amoura
- Department of Internal Medicine 2, National Reference Center for Histiocytosis, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
| | - Fleur Cohen-Aubart
- Department of Internal Medicine 2, National Reference Center for Histiocytosis, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
| | - Jean-François Emile
- Anatomopathology Laboratory, Ambroise Paré Hospital, APHP, Paris-Saclay University, Boulogne-Billancourt, France
| | - Frédéric Tankéré
- ENT Department, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
| | - Julien Haroche
- Department of Internal Medicine 2, National Reference Center for Histiocytosis, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
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4
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Abstract
Histiocytosis is a group of rare diseases characterized by inflammation and accumulation of cells derived from monocytes and macrophages in different tissues. The symptoms are highly variable, from mild forms with involvement of a single organ to severe multisystem forms that can be life compromising. The diagnosis of histiocytosis is based on the clinic, radiological findings and pathological anatomy. A biopsy of the affected tissue is recommended in all cases as it may have therapeutic implications. During the last decade, some mutations have been identified in the affected tissue that condition activation of the MAPK/ERK and PI3K/AKT pathway, in a variable proportion depending on the type of histiocytosis. In this review we mainly focus on Langerhans Cell Histiocytosis, Erdheim-Chester Disease and Rosai-Dorfman Disease.
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Affiliation(s)
- Gemma Rocamora-Blanch
- Servicio de Medicina Interna, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España; Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España.
| | - Fina Climent
- Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Servicio de Anatomía Patológica, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Xavier Solanich
- Servicio de Medicina Interna, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España; Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España
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5
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Rodríguez-Duque MS, Martín Soler P, González Vela MC, Gómez Román JJ. [Combined histiocytosis of the Langerhans group (Langerhans cell histiocytosis and Erdheim-Chester disease) in a 64-year-old man with BRAF and NRAS mutations: a case report]. Rev Esp Patol 2023; 56:186-190. [PMID: 37419557 DOI: 10.1016/j.patol.2021.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 06/07/2021] [Accepted: 07/04/2021] [Indexed: 07/09/2023]
Abstract
We present a case of a 64-year-old male with a history of Crohn's disease who presented with an episode of acute abdominal pain. He was being investigated for a dermatological lesion. A skin and lung biopsy both revealed histiocytosis of the "L" (Langerhans) group. The skin biopsy showed a proliferation of histiocytic cells expressing Langerin, CD1a and S100 and the molecular study was positive for the BRAF p.V600E mutation. In the lung biopsy, a proliferation of histiocytic cells was found, which were positive for CD68 and S100 and negative for Langerin and CD1a; mutations in NRAS c.38G>A in exon 2 (p.G13D) were also detected.
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Affiliation(s)
| | - Paula Martín Soler
- Servicio de Anatomía Patológica, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - M Carmen González Vela
- Servicio de Anatomía Patológica, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - Jose Javier Gómez Román
- Servicio de Anatomía Patológica, Hospital Universitario Marqués de Valdecilla, Santander, España
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6
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Kherabi Y, Chazal T, Emile JF, Allaham W, Mallart E, de Lastours V, Haroche J, Nguyen Y. A recurrent pleuropneumonia revealing Erdheim-Chester Disease. Respir Med Case Rep 2023; 43:101843. [PMID: 37091897 PMCID: PMC10119796 DOI: 10.1016/j.rmcr.2023.101843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/06/2023] [Indexed: 04/25/2023] Open
Abstract
Erdheim-Chester disease (ECD) is a rare form of L group histiocytosis, accounting for up to 1500 cases to date worldwide, which mainly affects men between their 5th and 7th decade of life. The most frequent manifestations are bone involvement, perirenal infiltration with an evocating appearance of "hairy kidneys", and a "coated aorta" aspect. Lung involvement in ECD is less common and includes pleural infiltration and interstitial lung disease. Herein, we report the case of a 76-year-old woman with recurrent pleuropneumonia revealing ECD.
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Affiliation(s)
- Yousra Kherabi
- Service de Médecine Interne, AP-HP.Nord, Hôpital Beaujon, Université Paris Cité, Clichy, France
| | - Thibaud Chazal
- Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre D'Immunologie et des Maladies Infectieuses (CIMI-Paris), Assistance Publique-Hôpitaux de Paris (APHP), Groupement Hospitalier Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | | | - Wassim Allaham
- Service de Radiologie, AP-HP.Nord, Hôpital Beaujon, Université Paris Cité, Clichy, France
| | - Elise Mallart
- Service de Médecine Interne, AP-HP.Nord, Hôpital Beaujon, Université Paris Cité, Clichy, France
| | - Victoire de Lastours
- Service de Médecine Interne, AP-HP.Nord, Hôpital Beaujon, Université Paris Cité, Clichy, France
- IAME Research Group, UMR-1137, Université de Paris, INSERM, Paris, France
| | - Julien Haroche
- Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre D'Immunologie et des Maladies Infectieuses (CIMI-Paris), Assistance Publique-Hôpitaux de Paris (APHP), Groupement Hospitalier Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Yann Nguyen
- Service de Médecine Interne, AP-HP.Nord, Hôpital Beaujon, Université Paris Cité, Clichy, France
- Corresponding author. Service de Médecine Interne, Hôpital Beaujon, 100 boulevard du Général Leclerc, 92100, Clichy, France.
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7
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El Sissy FN, Verkarre V, Larousserie F, Thiounn N, Haroche J, Emile JF. [Pelvic mass in 70 years old patient: Difficult diagnosis of Erdheim-Chester disease]. Ann Pathol 2021; 42:183-187. [PMID: 34969554 DOI: 10.1016/j.annpat.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 12/05/2021] [Indexed: 11/26/2022]
Abstract
Erdheim-Chester disease (EC) is a rare disease that is included in Group L in the 2016 revised classification of Langheransian histiocytoses. This disease may be clinically asymptomatic or manifest as a multi-systemic and life-threatening condition. All organs can be affected but typically there is bone involvement, retroperitoneal fibrosis, pituitary involvement, involvement of large vessels, lung, pleura or central nervous system. We are reporting a 70-year-old patient who, as of 2014, had a pelvic mass with retroperitoneal fibrosis and large vessel vasculitis without a definite diagnosis. Histological and molecular examination of the surgical specimen of the pelvic mass with the discovery of the BRAF V600E mutation provided new elements for the definitive diagnosis of Erdheim-Chester disease. We will describe the clinical, histological and molecular features to be known in EC disease.
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Affiliation(s)
| | - Virginie Verkarre
- Service de pathologie, hôpital Européen Georges-Pompidou, Paris, France
| | | | - Nicolas Thiounn
- Service d'urologie, hôpital Européen Georges-Pompidou, Paris, France
| | - Julien Haroche
- Service de médecine interne, hôpital La Pitié Salpétrière, Paris, France
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8
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Chasseur P, Kyriakopoulou M, Vokaer B, Beukinga I, Casado Arroyo R, Cogan E, Couturier B. A cytologic diagnosis of BRAF V600E Erdheim-Chester disease on pericardial fluid. Acta Clin Belg 2017; 72:369-371. [PMID: 28222655 DOI: 10.1080/17843286.2017.1290861] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
We report the case of a 74-year-old woman admitted to the emergency unit for resting dyspnea. Clinical presentation, cardiac MRI and echocardiography were consistent with cardiac tamponade requiring emergency pericardiocentesis. Cytologic examination of the pericardial fluid revealed the presence of CD68pos CD1aneg S100neg foamy histiocytes (Fig. 1). Additional investigations complied with the diagnosis of Erdheim-Chester histiocytosis. Treatment with αIFN was initiated but the patient developed severe neutropenia that contraindicated further administration. The detection of BRAFV600E mutation on histiocytes isolated from the pericardial liquid and CNS involvement (cerebral masses) prompted the administration of vemurafenib, a selective BRAFV600E kinase inhibitor. Four months after the initiation of low-dose vemurafenib, pericarditis almost resolved and cerebral masses decreased by 50% (Fig. 2). To our knowledge, analysis of pericardial fluid allowing the diagnosis of Erdheim-Chester disease and the detection of the BRAFV600E mutation has in fact been rarely described in the literature. This case report and the successful evolution under vemurafenib also support the use of BRAFV600E inhibitors in αIFN-intolerant patients with BRAFV600E mutation, particularly in case of heart and central nervous system involvement.
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Affiliation(s)
- P. Chasseur
- Internal Medicine Unit, Erasme Hospital, Université Libre de Bruxelles, Anderlecht, Belgium
| | - M. Kyriakopoulou
- Cardiology Unit, Erasme Hospital, Université Libre de Bruxelles, Anderlecht, Belgium
| | - B. Vokaer
- Internal Medicine Unit, Erasme Hospital, Université Libre de Bruxelles, Anderlecht, Belgium
| | - I. Beukinga
- Immunobiology, Hematology and Transfusion Unit, Erasme Hospital, Université Libre de Bruxelles, Anderlecht, Belgium
| | - R. Casado Arroyo
- Cardiology Unit, Erasme Hospital, Université Libre de Bruxelles, Anderlecht, Belgium
| | - E. Cogan
- Internal Medicine Unit, Erasme Hospital, Université Libre de Bruxelles, Anderlecht, Belgium
| | - B. Couturier
- Internal Medicine Unit, Erasme Hospital, Université Libre de Bruxelles, Anderlecht, Belgium
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Techavichit P, Sosothikul D, Chaichana T, Teerapakpinyo C, Thorner PS, Shuangshoti S. BRAF V600E mutation in pediatric intracranial and cranial juvenile xanthogranuloma. Hum Pathol 2017; 69:118-122. [PMID: 28504206 DOI: 10.1016/j.humpath.2017.04.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 04/07/2017] [Indexed: 11/15/2022]
Abstract
Juvenile xanthogranuloma (JXG) is a cutaneous form of non-Langerhans cell histiocytosis, primarily affecting children. The lesion is presumed to originate from either macrophages or dermal dendritic cells. JXG can rarely present as an isolated intracranial lesion and, in contrast to the dismal outcome of patients with systemic disease, cranial JXG has been shown to carry a more favorable prognosis. Here, we report for the first time 3 pediatric cases of JXG with a BRAF V600E mutation, 2 with intracranial lesions and 1 with cranial lesions. Although these intracranial/cranial lesions have been referred to as JXG, they likely differ from cutaneous JXG in both the clinical features and BRAF status. It may be more appropriate to classify intracranial/cranial JXG in the same group as Langerhans cell histiocytosis and Erdheim-Chester disease, which also have a BRAF V600E mutation. Further study of BRAF status in a larger series of JXG is warranted.
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Affiliation(s)
- Piti Techavichit
- Division of Hematology and Oncology, Department of Pediatric, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Darintr Sosothikul
- Division of Hematology and Oncology, Department of Pediatric, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Thiamjit Chaichana
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Chinachote Teerapakpinyo
- Chulolongkorn GenePRO Center, Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Paul Scott Thorner
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; Department of Laboratory Medicine, Hospital for Sick Children and University of Toronto, Toronto M5G 1X8, Canada
| | - Shanop Shuangshoti
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; Chulolongkorn GenePRO Center, Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
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10
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Abstract
Erdheim-Chester disease (ECD) is a rare xanthogranulomatous disease in which orbital involvement can have devastating outcomes. Through a case report and review of the ophthalmic literature, we explore orbital findings, disease progression, and treatment options. Cases of orbital involvement in Erdheim-Chester disease were identified in the ophthalmic literature with a PubMed query and review of cited references. A total of 14 publications reporting 19 separate cases that included ophthalmic examination data were identified. Patient ages ranged from 26-77 years with a mean age of 50 years. Seventy-four percent (14/19) were men. Vision progression to no light perception was found in 32% (6/19) of the patients. Reviewed cases reported a variety of medical and surgical treatment approaches, however, only 53% reported cases (10/19) demonstrated disease improvement or stabilization. Erdheim-Chester disease with orbital involvement is a devastating disease with a poor prognosis. Awareness of this entity by the ophthalmologist is important as orbital signs and symptoms may manifest early, and orbital biopsy is often crucial to the definitive diagnosis.
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Affiliation(s)
- Helen Merritt
- a Ruiz Department of Ophthalmology and Visual Science , The University of Texas Health Science Center at Houston , Houston , Texas , USA
| | - Margaret L Pfeiffer
- a Ruiz Department of Ophthalmology and Visual Science , The University of Texas Health Science Center at Houston , Houston , Texas , USA
| | - Karina Richani
- a Ruiz Department of Ophthalmology and Visual Science , The University of Texas Health Science Center at Houston , Houston , Texas , USA
- b Robert Cizik Eye Clinic , Houston , Texas , USA
| | - Margaret E Phillips
- a Ruiz Department of Ophthalmology and Visual Science , The University of Texas Health Science Center at Houston , Houston , Texas , USA
- b Robert Cizik Eye Clinic , Houston , Texas , USA
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11
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Roverano S, Gallo J, Ortiz A, Migliore N, Eletti M, Paira S. Erdheim-Chester disease: description of eight cases. Clin Rheumatol 2016; 35:1625-9. [PMID: 27106544 DOI: 10.1007/s10067-016-3269-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 04/05/2016] [Accepted: 04/07/2016] [Indexed: 11/25/2022]
Abstract
Erdheim-Chester disease, although rare, has a wide range of manifestations. It is characterized by the xanthomatous infiltration of tissues by spumous histiocytes, surrounded by fibrosis. The symptoms can vary from bone pain, diabetes insipidus, exophthalmos, xanthelasmas, cardiovascular involvement, bilateral adrenal enlargement, renal impairment, testis infiltration, interstitial lung disease to retroperitoneal fibrosis with perirenal and/or ureteral obstruction. We present eight cases, four of them with only breast involvement and the others with bone, cardiovascular, central nervous system, and renal involvement. All showed infiltrates of histiocytes and fibrosis on microscopic evaluation and positive CD68 and negative CD1a on immunohistochemical stains.
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Affiliation(s)
- S Roverano
- Rheumatology Section, José María Cullen Hospital, Av. Freyre 2150, (3000), Santa Fe, Argentina.
| | - J Gallo
- Rheumatology Section, José María Cullen Hospital, Av. Freyre 2150, (3000), Santa Fe, Argentina
| | - A Ortiz
- Rheumatology Section, José María Cullen Hospital, Av. Freyre 2150, (3000), Santa Fe, Argentina
| | - N Migliore
- Department of Pathology, José María Cullen Hospital, Av. Freyre 2150, (3000), Santa Fe, Argentina
| | - Mónica Eletti
- Department of Pathology, José María Cullen Hospital, Av. Freyre 2150, (3000), Santa Fe, Argentina
| | - S Paira
- Rheumatology Section, José María Cullen Hospital, Av. Freyre 2150, (3000), Santa Fe, Argentina
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12
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Poiroux L, Paycha F, Polivka M, Ea HK. Efficacy of zoledronic acid in Erdheim-Chester disease: A case report. Joint Bone Spine 2016; 83:573-5. [PMID: 26987264 DOI: 10.1016/j.jbspin.2015.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 10/21/2015] [Indexed: 11/20/2022]
Abstract
Erdheim-Chester disease is rare form of non-Langerhans cell histiocytosis characterized by organ infiltration of CD68+ CD1a- histiocytes. Between 500 and 600 cases have been reported. It is a multifaceted disease ranging from a solely asymptomatic bone to a fatal multisystem pattern. Bone involvement occurs in more than 90% of cases. Although not life-threatening, bone localizations can be responsible of difficult-to-treat pain and disability. Treatment depends on lesion severity. Bisphosphonates have been reported to be efficient and safe in bone involvement. We report a case of a biopsy proven bone Erdheim-Chester disease in a 65-year-old woman with history of breast cancer. Her pain was relieved after 3 perfusions of zoledronic acid and the efficiency remained at one year of follow-up.
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Couvreur T, Lipcsei G, Nchimi A. Imaging Assessment of Periaortic Inflammation in Erdheim-Chester Disease. Aorta (Stamford) 2013; 1:146-148. [PMID: 30356917 DOI: 10.12945/j.aorta.2013.13-023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 05/25/2013] [Indexed: 11/18/2022]
Abstract
Reaching etiologic diagnoses for retroperitoneal fibrosis may be challenging. We report the case of a 75-year old male with history of ruptured abdominal aortic aneurysm and subsequent retroperitoneal fibrosis who developed four years later a soft tissue infiltration surrounding the ascending thoracic aorta. Thanks to his medical records and multimodality imaging assessment, the patient escaped an open-chest biopsy through histolgical reassessment of the abdominal periaortic samples that allowed the definitive diagnosis of Erdheim-Chester disease, a rare non-Langerhans histiocytosis.
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Affiliation(s)
- Thierry Couvreur
- Department of Medical Imaging, University Hospital-Sart Tilman, Liège, Belgium
| | | | - Alain Nchimi
- Department of Medical Imaging, University Hospital-Sart Tilman, Liège, Belgium
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