Sakr Hany I, Buckley Kaila, Baiocchi Robert, Zhao Weiqiang John, Hemminger Jessica A
Department of Pathology, The Ohio State University Wexner Medical Center, 410 W. 10th Ave, N#308, Columbus, OH, 43210, USA.
Department of Internal Medicine (Hematology), The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Diagn Pathol. 2018 Nov 24;13(1):94. doi: 10.1186/s13000-018-0772-2.
Erdheim Chester disease (ECD) is a rare, non-Langerhans cell histiocytosis characterized by widespread tissue infiltration by CD68-positive, CD1a-negative foamy histiocytes. ECD can be difficult to identify, and diagnosis relies on the presence of histiocytes with certain histologic and immunophenotypic features in an appropriate clinical and radiologic setting. Clinical signs and symptoms are variable depending on which organ systems are involved. Most patients have at least skeletal involvement with bone pain as well as fatigue. Other common manifestations include diabetes insipidus, cardiac, periaortic, or retro-orbital infiltration/fibrosis, kidney impairment, xanthelasmas, among others.
Herein, we describe a case of BRAF-mutation positive ECD in a patient with Burkitt lymphoma, and we review recent literature.
Underlying BRAF and other MAPK pathway mutations are identified in approximately 50% of cases of ECD, which aids in diagnosis as well as enables novel targeted treatments. ECD patients have an increased risk of myeloid neoplasms; however, unlike other histiocytoses, an association with lymphoproliferative disorders has not been recognized.
厄尔德海姆-切斯特病(ECD)是一种罕见的非朗格汉斯细胞组织细胞增多症,其特征为CD68阳性、CD1a阴性的泡沫状组织细胞广泛浸润组织。ECD可能难以识别,诊断依赖于在合适的临床和影像学背景下出现具有特定组织学和免疫表型特征的组织细胞。临床体征和症状因受累的器官系统而异。大多数患者至少有骨骼受累,伴有骨痛和疲劳。其他常见表现包括尿崩症、心脏、主动脉周围或眶后浸润/纤维化、肾功能损害、睑黄瘤等。
在此,我们描述了1例患有伯基特淋巴瘤的BRAF突变阳性ECD患者,并回顾了近期文献。
在大约50%的ECD病例中发现了潜在的BRAF和其他丝裂原活化蛋白激酶(MAPK)途径突变,这有助于诊断并实现新的靶向治疗。ECD患者发生髓系肿瘤的风险增加;然而,与其他组织细胞增多症不同,尚未发现其与淋巴增殖性疾病有关联。