Peixoto André, Martins Guilherme, Leitão João
Serviço de Imagiologia Geral, Centro Hospitalar Universitário Lisboa Norte, Av. Prof. Egas Moniz, Lisboa 1649-035, Portugal.
Serviço de Imagiologia Neurológica, Centro Hospitalar Universitário Lisboa Norte, Lisboa 1649-035, Portugal.
Radiol Case Rep. 2022 Oct 11;17(12):4859-4867. doi: 10.1016/j.radcr.2022.08.097. eCollection 2022 Dec.
Erdheim-Chester disease is a rare and multisystemic entity. It results from the infiltration of tissues by foamy histiocytes. The etiology is unknown, but there are mutations in the MAPK pathway in over 80% of patients, more frequently BRAF mutation. The most commonly affected organs and systems are the skeleton, central nervous system, cardiovascular system, kidney, lungs, and skin. The most common clinical manifestations are bone pain, usually in the lower limbs, and diabetes insipidus. The diagnosis is challenging. It requires a combination of clinical, radiological, histopathological, and molecular findings. We present the case of a patient with typical clinical and radiological manifestations: bone pain and diabetes insipidus at presentation, bilateral long bone cortical sclerosis, hairy kidney appearance, coated aorta, right atrium pseudotumor, and periorbital masses.
厄德里希-切斯特病是一种罕见的多系统疾病。它由泡沫状组织细胞浸润组织所致。病因不明,但超过80%的患者存在丝裂原活化蛋白激酶(MAPK)途径突变,其中BRAF突变更为常见。最常受累的器官和系统包括骨骼、中枢神经系统、心血管系统、肾脏、肺和皮肤。最常见的临床表现是骨痛,通常发生在下肢,以及尿崩症。诊断具有挑战性。它需要综合临床、放射学、组织病理学和分子学检查结果。我们报告一例具有典型临床和放射学表现的患者:初诊时出现骨痛和尿崩症,双侧长骨皮质硬化,肾脏呈毛玻璃样外观,主动脉有包膜,右心房假瘤,以及眶周肿块。