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[与 Erdheim-Chester 病相关的内分泌腺特征]

[Characterization of Endocrine Glands Involved in Erdheim-Chester Disease].

作者信息

Tang Yi, Wu Zhe, Wei Ze-Min, Sun Hao, Jin Zheng-Yu

机构信息

Department of Endocrinology,Fushun Central Hospital,Fushun,Liaoning 113006,China.

Department of Radiology,State Key Laboratory of Complex Severe and Rare Diseases,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2022 Jun;44(3):428-432. doi: 10.3881/j.issn.1000-503X.14477.

Abstract

Objective To investigate the clinical and imaging characteristics of endocrine glands involved in Erdheim-Chester disease (ECD).Methods A retrospective analysis was performed on 48 ECD cases pathologically diagnosed from January 2014 to October 2020 in Peking Union Medical College Hospital,including 22 cases of endocrine gland involvement.The clinical,imaging,and pathological characteristics were summarized. Results Pituitary was involved in 17 cases (17/48,35.4%),adrenal gland in 8 cases (8/48,16.7%),and both pituitary and adrenal gland in 3 cases (3/48,6.25%).The most common symptom in patients with pituitary involvement was central diabetes insipidus (13/17,76.5%),and the T1-weighted imaging showed posterior pituitary hypersignal disappearance,pituitary stalk thickening,and abnormally enhanced pituitary nodules.The most common symptom in patients with adrenal gland involvement was adrenal function reduction (3/8,37.5%),and the CT scanning showed diffuse thickening of adrenal glands.BRAF V600E mutation was positive in 13 (13/22,59.1%) cases with ECD involving endocrine glands.Conclusion Pituitary and adrenal glands are the most common sites of ECD involving endocrine glands.A definite diagnosis can be achieved by combining clinical,imaging,and pathological characteristics for timely treatment.

摘要

目的 探讨厄德里希-切斯特病(ECD)累及内分泌腺的临床及影像学特征。方法 回顾性分析2014年1月至2020年10月在北京协和医院经病理确诊的48例ECD患者,其中累及内分泌腺者22例,总结其临床、影像学及病理特征。结果 垂体受累17例(17/48,35.4%),肾上腺受累8例(8/48,16.7%),垂体和肾上腺均受累3例(3/48,6.25%)。垂体受累患者最常见的症状是中枢性尿崩症(13/17,76.5%),T1加权成像显示垂体后叶高信号消失、垂体柄增粗及垂体结节异常强化。肾上腺受累患者最常见的症状是肾上腺功能减退(3/8,37.5%),CT扫描显示肾上腺弥漫性增厚。22例ECD累及内分泌腺患者中13例(13/22,59.1%)BRAF V600E突变阳性。结论 垂体和肾上腺是ECD累及内分泌腺最常见的部位。结合临床、影像学及病理特征可明确诊断,以便及时治疗。

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