Department of Radiology, Pusan National University Hospital, Medical Research Institute, Busan, Korea.
Skeletal Radiol. 2011 Nov;40(11):1421-6. doi: 10.1007/s00256-010-1078-y. Epub 2010 Dec 29.
The purpose of this article was to evaluate the radiologic findings of adult pelvis and appendicular skeletal Langerhans cell histiocytosis (LCH), emphasizing the CT and MR findings.
The images of nine patients with pathologically proven LCH (five men and four women; mean age, 37.11 years) were retrospectively reviewed. Imaging analysis was confined to the long and flat bones. CT scans were performed in five patients and MR imaging was performed in eight. Images were assessed for the following features on CT and MRI: the location and number of lesions; the presence of cortical destruction, endosteal scalloping, and a periosteal reaction on CT or MRI; the margin of soft tissue masses, the presence of bone marrow edema, and a "budding" appearance on MRI; and the presence of sclerotic margins or septations on CT.
The involved skeletal sites were the pelvis (seven), femurs (five), humeri (two), tibias (two), fibula (one), clavicle (one), scapula (one), and sternum (one). Endosteal scalloping, a periosteal reaction, and a budding appearance were common on MRI or CT images. Although cortical destruction and the soft tissue lesion formation were rare, soft tissue masses had well-defined margins.
Endosteal scalloping and a budding appearance with a periosteal reaction on CT and MRI may be helpful signs for differentiation of LCH from malignant tumors in adults.
本文旨在评估成人骨盆和四肢骨骼朗格汉斯细胞组织细胞增生症（LCH）的放射学表现，重点介绍 CT 和 MR 表现。
回顾性分析 9 例经病理证实的 LCH 患者（男 5 例，女 4 例；平均年龄 37.11 岁）的图像。影像学分析仅限于长骨和扁骨。5 例患者行 CT 扫描，8 例行 MR 成像。对 CT 和 MRI 上的以下特征进行评估：病变的位置和数量；骨皮质破坏、骨内膜扇贝状改变和骨膜反应的存在；软组织肿块的边界、骨髓水肿和 MRI 上的“发芽”表现；CT 上的硬化缘或分隔。
受累骨骼部位为骨盆（7 例）、股骨（5 例）、肱骨（2 例）、胫骨（2 例）、腓骨（1 例）、锁骨（1 例）、肩胛骨（1 例）和胸骨（1 例）。骨内膜扇贝状改变、骨膜反应和 MRI 或 CT 上的“发芽”表现常见。虽然皮质破坏和软组织肿块形成少见，但软组织肿块边界清楚。
CT 和 MRI 上的骨内膜扇贝状改变和“发芽”表现伴骨膜反应可能有助于鉴别成人 LCH 与恶性肿瘤。
