Adult Langerhans Cell Histiocytosis Diagnosed by Biopsy of the Skull Tumor Generated after Craniotomy.
Adult Langerhans Cell Histiocytosis Diagnosed by Biopsy of the Skull Tumor Generated after Craniotomy.
复制标题
DOI：
10.2176/nmccrj.cr.2020-0094
复制
发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Saito R
中科院分区：
文献类型：
--
作者：
Kono M;Inomoto C;Horiguchi T;Sugiyama I;Nakamura N;Saito R
朗格汉斯细胞组织细胞增生症(LCH)是一种以朗格汉斯细胞增殖为特征的疾病。大多数LCH病例发生在儿童，尽管也可以见于成人。我们遇到了一例成人LCH病例。一名44岁的女性被诊断为尿崩症，她接受了头部磁共振成像(MRI)，发现鞍区和鞍上区Gd强化的肿块。催乳素水平高，开卡麦角林。肿块的大小缩小了，所以我们认为肿瘤是催乳素瘤。然而，经过4年的观察，它又一次上升。垂体柄病变经颅入路活检。组织学诊断最初为神经节细胞瘤。病人在手术后主诉背部疼痛。活检三个月后，计算机断层扫描(CT)显示全身多处溶骨性病变。其中一个颅骨溶骨性病变被切除以确定诊断。头骨的病理检查导致了LCH的诊断。我们的结论是，虽然没有得到典型的病理表现，但垂体柄的病变是类似神经节细胞瘤的LCH。结论：LCH可作为成人尿崩症合并下丘脑-垂体损害的鉴别诊断。
Langerhans cell histiocytosis (LCH) is a disease characterized by the proliferation of Langerhans cells. Most cases of LCH occur in children, although it can be seen in adults as well. We encountered an adult case of LCH. A 44-year-old woman who was diagnosed as diabetes insipidus underwent a magnetic resonance imaging (MRI) of the head which revealed sellar and suprasellar gadolinium-enhanced mass. Prolactin level was high and cabergoline was prescribed. The size of this mass had reduced, so we supposed the tumor was prolactinoma. However, after 4 years of observation, it had increased once again. The biopsy of pituitary stalk lesion was performed via transcranial approach. The histological diagnosis was initially gangliocytoma. The patient complained of back pain after surgery. Three months after the biopsy, a computed tomography (CT) scan revealed multiple osteolytic lesions throughout the entire body. One of the osteolytic lesions of the skull was removed to determine the diagnosis. The pathological examination of the skull led to a diagnosis of LCH. We concluded retrospectively that the lesion of the pituitary stalk was LCH mimicking gangliocytoma though classical pathological findings were not obtained. In conclusion, LCH should be considered as a differential diagnosis in adult cases of diabetes insipidus with hypothalamic–pituitary lesion.