Grothe C, Urbach H, Bös M, Ko Y, Schröder R
Neurologische Universitätsklinik Bonn, Sigmund Freud Strasse 25, 53105 Bonn.
Nervenarzt. 2001 Jun;72(6):449-52. doi: 10.1007/s001150050778.
We present a 50-year-old patient with a slowly progressive cerebellar syndrome, left-sided exophthalmos, secondary hypogonadism, and multiple pleomorphous skin alterations. The diagnosis of Erdheim-Chester disease was established by the radiological detection of a left-sided retrobulbar space-occupying mass, a hypophysial stalk lesion, alterations in both cerebellar hemispheres, retroperitoneal imbibition, osteolytic/osteosclerotic changes in the metaphysis and diaphysis of the long bones, and a skin biopsy with histological detection of a non-Langerhans-cell histiocytosis. The etiology of the Erdheim-Chester disease is unknown. Cerebral manifestations of this rare disease have been documented in only a very few cases. Whereas the extracranial alterations are due to pathologic histiocyte proliferation, cerebellar changes are considered to be the result of demyelinisation or infiltration of xanthogranulomas.
我们报告一例50岁患者,患有缓慢进展的小脑综合征、左侧眼球突出、继发性性腺功能减退以及多处多形性皮肤改变。通过影像学检查发现左侧球后占位性肿块、垂体柄病变、双侧小脑半球改变、腹膜后浸润、长骨干骺端和骨干的溶骨性/骨硬化性改变,以及皮肤活检组织学检测发现非朗格汉斯细胞组织细胞增多症,从而确诊为厄尔海姆-切斯特病。厄尔海姆-切斯特病的病因尚不清楚。这种罕见疾病的脑部表现仅在极少数病例中有记录。颅外改变是由于病理性组织细胞增殖所致,而小脑改变被认为是脱髓鞘或黄色肉芽肿浸润的结果。