Brown Christopher W, Jarvis James G, Letts Mervyn, Carpenter Blair
Division of Orthopaedic Surgery, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ont.
Can J Surg. 2005 Jun;48(3):230-6.
We wished to evaluate the treatment methods for vertebral Langerhans cell histiocytosis (LCH) (a rare reticuloendothelial disorder) at a tertiary care pediatric centre and compare treatment and outcomes with those reported in the recent literature.
A total of 55 charts were retrieved between 1980 and 2003 for children with LCH. Only those children who were under 18 years of age, had a diagnosis of LCH, histiocytosis X or eosinophilic granuloma and had documented vertebral involvement were included. The data collected were compared with data in the literature with respect to epidemiologic features, symptoms, investigations and procedures done, treatment, outcome and follow-up.
Of the 8 children who met the inclusion criteria for vertebral LCH, the most common presenting complaint was back or neck pain. The thoracic vertebrae were most commonly affected followed equally by cervical and lumbar spines. Most children underwent a complete diagnostic work-up. A single solitary lesion was found in only 1 child. Biopsies were attempted in all cases with 6 positive results. Treatment varied depending on the severity of the presenting complaint; however, none of the tumours was completely resected. Follow-up averaged 3.4 years, and only 1 child has had a recurrence.
A multidisciplinary investigation is recommended for children with suspected vertebral LCH. Treatment depends on the severity of the disease.
我们希望评估一家三级儿科护理中心对椎体朗格汉斯细胞组织细胞增多症（LCH，一种罕见的网状内皮系统疾病）的治疗方法，并将治疗情况和结果与近期文献报道的进行比较。
检索了1980年至2003年间55例LCH患儿的病历。仅纳入年龄在18岁以下、诊断为LCH、组织细胞增多症X或嗜酸性肉芽肿且有椎体受累记录的患儿。将收集的数据在流行病学特征、症状、检查及所做的操作、治疗、结果和随访等方面与文献中的数据进行比较。
在符合椎体LCH纳入标准的8名儿童中，最常见的主诉是背部或颈部疼痛。胸椎最常受累，其次是颈椎和腰椎，受累情况相同。大多数儿童接受了全面的诊断检查。仅1名儿童发现单个孤立病变。所有病例均尝试进行活检，6例结果为阳性。治疗根据主诉的严重程度而异；然而，没有一个肿瘤被完全切除。随访平均3.4年，只有1名儿童复发。
对于疑似椎体LCH的儿童，建议进行多学科检查。治疗取决于疾病的严重程度。
