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[耳部嗜酸性肉芽肿。结合2例病例报告的综述]

[Eosinophilic granuloma of the ear. General review apropos of 2 case reports].

作者信息

Paquelin F, Cotin G, Valdazo A

出版信息

Ann Otolaryngol Chir Cervicofac. 1979 Apr-May;96(4-5):251-60.

PMID:314769
Abstract

The eosinophilic granuloma is part of the histiocytosis X classification, having a common histological substratum, the granuloma, which is characterized by a proliferation of histiocytes (reticulo-endothelial cells) and a cytoplasmic inclusion body (the X body) whose étiopathogenic significance is not yet established. These histiocytes are accompanied by other cells and in particular granulocytes, the majority of which are eosinophils. Histiocyte proliferation leads to a destruction of bone which is the organ preferentially affected. At first there is osteolysis (this explains the lacunar aspects seen radiologically) followed by sclerosis. The clinical classification established by Lichtenstein in 1953 outlines the tissue form (eosinophil granuloma), the acute disseminated form (Letterersive) and the chronic disseminated form (Hand-Schüller-Christian). This classification is still accepted today but it needs to be refined to include the transitionary forms, and solitary bone granulomas whose long terme evolutive nature it is impossible to measure clinically, biologically, or histologically. From our observation we note that therapy (surgery, radiotherapy, chemotherapy) is effective in controlling the acute growth spurts in a majority of the cases but does not seem to effect the potential long terme evolution.

摘要

嗜酸性肉芽肿是组织细胞增多症X分类的一部分,具有共同的组织学基础,即肉芽肿,其特征是组织细胞(网状内皮细胞)增殖和一种胞质包涵体(X小体),其发病机制意义尚未明确。这些组织细胞伴有其他细胞,特别是粒细胞,其中大多数是嗜酸性粒细胞。组织细胞增殖导致骨破坏,骨是优先受累的器官。起初是骨质溶解(这解释了放射学上所见的腔隙样表现),随后是硬化。利希滕斯坦于1953年建立的临床分类概述了组织形式(嗜酸性肉芽肿)、急性播散形式(勒特尔病)和慢性播散形式(汉-许-克病)。这种分类至今仍被接受,但需要完善以纳入过渡形式以及孤立性骨肉芽肿,其长期演变性质在临床、生物学或组织学上都无法测量。从我们的观察来看,我们注意到治疗(手术、放疗、化疗)在大多数情况下对控制急性生长突增有效,但似乎对潜在的长期演变没有影响。

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