脊椎朗格汉斯组织细胞增生症探讨  

Langerhans Cell Histiocytosis of the Spine

作　　者：吴启秋[1] 林羽[1] 管波清[1] 徐双铮[1] 程宏[1] 

机构地区：[1]北京市结核病胸部肿瘤研究所

出　　处：《结核病与胸部肿瘤》2005年第4期261-266,共6页Tuberculosis and Thoracic Tumor

摘　　要：目的探索脊椎朗格汉斯组织细胞增生症（LCH）诊断与治疗的经验。方法回顾性分析脊椎LCH12例，其中男7例．女5例，年龄2-11岁，并发四肢轻瘫2例。脊椎以外骨病变5例，多系统病变5例，采取化疗3例，放疗1例，手术2例，并四肢轻瘫化疗加手术2例，4例未处理。结果脊髓功能恢复2例，经2～11年随访，9例椎体有不同程度恢复，无1例复发或死亡。失访1例。X线、CT表现椎体溶骨性改变，呈楔形变，有时病变可累及椎弓根，甚至椎板。两相邻椎体受累时，椎间隙变窄。结论脊椎LCH的CT和X线表现多样，结合有关的临床资料，对多系统或多骨骼受累的脊椎LCH与脊椎其他病变可做出诊断。无全身症状，无进行性脊柱畸形的脊椎LCH密切观察，无需特殊处理。Object To study the diagnosis and treatment of Langerhans cell histiocytosis（LCH）in the spine. Methods Twelve cases （male 7, female 5, 2 - 11 years of age） with LCH of spine were reviewed retrospectively. Five cases had extra-spinal skeletal lesions and 5 eases had multi-systemlc lesions. Of all cases, 2 cases with tetraplegia underwent chemotherapy and surgery, 3 treated with chemotherapy, 1 with radiotherapy, and 4 without any treatment. Results Two cases with tetraplegia recovered. Nine cases restored spontaneously to various extent of vertebral height for 2-11 year follow-up. 1 case lost contact. Radiographs and CT showed osteolytic appearance of the vertebrae, involved in pedicles and even lamellae, and the disc between two successive LCH vertebral lesions would become narrow. Conclusions Based on clinical findings and muhi- skeletal lesions and/or multisystemic lesions, it is possible to differentially diagnose between LCH spine and the other spinal involvements by studying their characteristics of images. For LCH of the spine in the absence of systemic disease or spinal deformity, follow-up is necessary only.

关 键 词：朗格汉斯组织细胞增生症 脊椎 计算机体层摄影术 化疗 外科手术 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤] R816.8[医药卫生—临床医学]