Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS Reggio Emilia, Reggio Emilia, Italy.
Department of Pathology and Laboratory Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA.
Histopathology. 2018 Jul;73(1):167-172. doi: 10.1111/his.13501. Epub 2018 Apr 19.
Erdheim-Chester disease represents a clonal systemic proliferation of histiocytes. Bone is the most common site of involvement, although almost any organ, including the lungs, can be affected.
The diagnosis of Erdheim-Chester disease can be difficult, owing to its rarity and protean presentation. Correlation between clinical, radiological and histological findings is mandatory for identification of the disease. Foamy histiocytes, lacking Langerhans cell markers, represent the typical histological findings, although their absence does not rule out Erdheim-Chester disease. Identification of BRAF mutation can be helpful in making the diagnosis, and allows for the development and application of targeted therapies in this setting.
Herein, we describe two cases presenting with lung involvement and vertebral lesions, lacking the more typical long-bone involvement. One case histologically mimicked Rosai-Dorfman disease. However, both cases harboured the pathognomonic BRAFV600E mutation.
埃勒-当斯-切斯特病( Erdheim-Chester disease )是一种组织细胞的克隆性系统性增生。骨骼是最常受累的部位,尽管几乎任何器官,包括肺部,都可能受到影响。
由于埃勒-当斯-切斯特病的罕见性和多种表现形式,其诊断可能具有挑战性。为了确定该疾病,必须将临床、放射学和组织学发现进行关联。缺乏朗格汉斯细胞标志物的泡沫状组织细胞是典型的组织学发现,尽管其不存在并不排除埃勒-当斯-切斯特病。BRAF 突变的鉴定有助于做出诊断,并允许在此背景下开发和应用靶向治疗。
本文描述了两例表现为肺部受累和椎骨病变的病例,缺乏更典型的长骨受累。一例病例在组织学上类似于罗萨-多夫曼病。然而,这两例病例均存在特征性的 BRAFV600E 突变。