Chomette G, Auriol M, Ragot J P, Guilbert F
Service d'Anatomie pathologique, Hôpital de la Pitié, Paris.
Rev Stomatol Chir Maxillofac. 1987;88(5):334-8.
61 cases of histiocytosis X of jaws were reported here. They occurred more often in man (72% of men) than in woman, with an average age of 27 years. The mandible was affected more frequently than the maxilla. Clinically, dental expulsion, gingival swelling, fractures or pain were the usual symptoms. Roentgenographic examination showed either central or peripheral (alveolar bone) osteolytic areas. The histologic diagnosis was easy when eosinophilic polymorphous leukocytes or histiocytes were preponderant. In the other cases, immunohistochemistry (positivity of S-100 protein) and electron microscopy (presence of Birbeck granules about paraffin embedded specimens) were of a great usefulness. The prognosis of the disease was mainly related to the diffusion of lesions to other skeletal portions or extraskeletal localizations (37% of our cases). It has been improved by combination of chemotherapy to surgery (despite of frequent recurrences), 40 upon 45 patients are well after a follow-up of 2 to 10 years after the last localization.
本文报告了61例颌骨嗜酸性肉芽肿。男性发病多于女性（男性占72%），平均年龄27岁。下颌骨受累比上颌骨更常见。临床上，牙齿松动、牙龈肿胀、骨折或疼痛是常见症状。X线检查显示为中央型或周围型（牙槽骨）溶骨区。当嗜酸性多形核白细胞或组织细胞占优势时，组织学诊断容易。在其他病例中，免疫组织化学（S-100蛋白阳性）和电子显微镜检查（石蜡包埋标本中存在Birbeck颗粒）非常有用。该病的预后主要与病变扩散至其他骨骼部位或骨骼外定位有关（我们的病例中占37%）。化疗联合手术改善了预后（尽管复发频繁），45例患者中有40例在最后一次定位后随访2至10年情况良好。
