Huri Gazi, Çetik Rıza Mert, Gedikoğlu Gökhan, Garbis Nickolas
Department of Orthopedics and Traumatology, Hacettepe University Hospital, Ankara, Turkey.
Department of Pathology, Hacettepe University Hospital, Ankara, Turkey.
J Orthop Case Rep. 2020 Nov;10(8):6-10. doi: 10.13107/jocr.2020.v10.i08.1834.
Histiocytoses are rare disorders and most orthopedic surgeons are unfamiliar with this diagnosis. We report a case of synovial non-Langerhans cell histiocytosis (LCH) located in the shoulder, which has not been reported in the literature previously.
A 24-year-old female patient presented to our clinic with shoulder pain and decreased range of motion. MRI results suggested pigmented villonodular synovitis. Arthroscopic synovial debridement and biopsy were performed. Histologic examination came back as non-LCH of the shoulder. Hematology/oncology evaluation indicated localized disease and no further treatment was necessary. At the 6th month follow-up, the patient gained full shoulder motion and is symptom free.
This case represents a rare diagnosis of synovial non-LCH which should be considered in the differential diagnosis of synovial diseases. A misdiagnosis could result in inadequate treatment, and coordination with the hematology/oncology department is of utmost importance in the treatment of this neoplastic disease.
组织细胞增多症是罕见疾病，大多数骨科医生对这种诊断并不熟悉。我们报告一例位于肩部的滑膜非朗格汉斯细胞组织细胞增多症（LCH），此前文献中未见报道。
一名24岁女性患者因肩部疼痛和活动范围减小前来我院就诊。MRI结果提示色素沉着绒毛结节性滑膜炎。进行了关节镜下滑膜清创和活检。组织学检查结果为肩部非LCH。血液学/肿瘤学评估显示为局限性疾病，无需进一步治疗。在第6个月随访时，患者肩部活动完全恢复且无症状。
本病例代表了一种罕见的滑膜非LCH诊断，在滑膜疾病的鉴别诊断中应予以考虑。误诊可能导致治疗不足，在这种肿瘤性疾病的治疗中，与血液学/肿瘤学部门的协作至关重要。
