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梅奥诊所组织细胞增生症工作组共识声明:成人组织细胞肿瘤的诊断和评估——Erdheim-Chester 病、朗格汉斯细胞组织细胞增生症和 Rosai-Dorfman 病。

The Mayo Clinic Histiocytosis Working Group Consensus Statement for the Diagnosis and Evaluation of Adult Patients With Histiocytic Neoplasms: Erdheim-Chester Disease, Langerhans Cell Histiocytosis, and Rosai-Dorfman Disease.

机构信息

Division of Hematology, Mayo Clinic, Rochester, MN.

Department of Radiology, Mayo Clinic, Rochester, MN.

出版信息

Mayo Clin Proc. 2019 Oct;94(10):2054-2071. doi: 10.1016/j.mayocp.2019.02.023. Epub 2019 Aug 28.

Abstract

Histiocytic neoplasms, a rare and heterogeneous group of disorders, primarily include Erdheim-Chester disease, Langerhans cell histiocytosis, and Rosai-Dorfman disease. Due to their diverse clinical manifestations, the greatest challenge posed by these neoplasms is the establishment of a diagnosis, which often leads to a delay in institution of appropriate therapy. Recent insights into their genomic architecture demonstrating mitogen-activated protein kinase/extracellular signal-regulated kinase pathway mutations have now enabled potential treatment with targeted therapies in most patients. This consensus statement represents a joint document from a multidisciplinary group of physicians at Mayo Clinic who specialize in the management of adult histiocytic neoplasms. It consists of evidence- and consensus-based recommendations on when to suspect these neoplasms and what tests to order for the diagnosis and initial evaluation. In addition, it also describes the histopathologic and individual organ manifestations of these neoplasms to help the clinicians in identifying their key features. With uniform guidelines that aid in identifying these neoplasms, we hope to improve the awareness that may lead to their timely and correct diagnosis.

摘要

组织细胞肿瘤是一组罕见且异质性的疾病,主要包括 Erdheim-Chester 病、朗格汉斯细胞组织细胞增生症和 Rosai-Dorfman 病。由于其临床表现多样,这些肿瘤最大的挑战是建立诊断,这往往导致适当治疗的延迟。最近对其基因组结构的深入了解表明,丝裂原活化蛋白激酶/细胞外信号调节激酶通路突变可使大多数患者能够进行靶向治疗。本共识声明代表 Mayo 诊所一组专门从事成人组织细胞肿瘤管理的多学科医生的联合文件。它包含关于何时怀疑这些肿瘤以及为诊断和初始评估订购哪些检查的基于证据和共识的建议。此外,它还描述了这些肿瘤的组织病理学和单个器官表现,以帮助临床医生识别其关键特征。通过有助于识别这些肿瘤的统一指南,我们希望提高认识,从而实现及时和正确的诊断。

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