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Erdheim-Chester Disease

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초록

Erdheim-Chester disease (ECD) is a rare, non-Langerhans cell histiocytosis of unknown etiology, characterized by multiorgan involvement. ECD is usually diagnosed on the basis of characteristic radiologic and histopathological findings. Lesions may be skeletal and/or extraskeletal in location, and may include the skin, lung, heart, and central nervous system. We describe here a 68-year-old man with multiple yellowish plaques and a pinkish nodule on his face and scalp. He had been previously diagnosed with diabetes insipidus, and recently complained of coughing and dyspnea. Imaging studies showed multiple osteosclerotic lesions of the bones, a moderate amount of pericardial effusion, and multifocal infiltrative lesions in the perirenal space. Histopathological examination of the skin lesions revealed dermal infiltration of foamy histiocytes with multinuclear giant cells. Moreover, laparoscopic biopsy of the perirenal tissue revealed fibrosis with infiltrating foamy histiocytes being CD68-positive and S100-negative. Based on these findings, he was diagnosed with ECD with extraskeletal manifestations, and treated with interferonalpha. (Ann Dermatol 22(4) 439∼443, 2010)

Abstract

Erdheim-Chester disease (ECD) is a rare, non-Langerhans cell histiocytosis of unknown etiology, characterized by multiorgan involvement. ECD is usually diagnosed on the basis of characteristic radiologic and histopathological findings. Lesions may be skeletal and/or extraskeletal in location, and may include the skin, lung, heart, and central nervous system. We describe here a 68-year-old man with multiple yellowish plaques and a pinkish nodule on his face and scalp. He had been previously diagnosed with diabetes insipidus, and recently complained of coughing and dyspnea. Imaging studies showed multiple osteosclerotic lesions of the bones, a moderate amount of pericardial effusion, and multifocal infiltrative lesions in the perirenal space. Histopathological examination of the skin lesions revealed dermal infiltration of foamy histiocytes with multinuclear giant cells. Moreover, laparoscopic biopsy of the perirenal tissue revealed fibrosis with infiltrating foamy histiocytes being CD68-positive and S100-negative. Based on these findings, he was diagnosed with ECD with extraskeletal manifestations, and treated with interferonalpha. (Ann Dermatol 22(4) 439∼443, 2010)

참고문헌 (9)

  1. Veyssier-Belot C, "Erdheim-Chester disease.Clinical and radiologic characteristics of 59 cases", Medicine(Baltimore), 75, pp.157~169 (1996)
  2. Sheu SY, "Erdheim-Chester disease:case report with multisystemic manifestations including testes,thyroid,and lymph nodes,and a review of literature", J Clin Pathol, 57, pp.1225~1228 (2004)
  3. Myra C, "Treatment of Erdheim-Chester disease with cladri bine:a rational approach", Br J Ophthalmol, 88, pp.844~847 (2004)
  4. Dickson BC, "Systemic Erdheim-Chester disease", Virchows Arch, 452, pp.221~227 (2008)
  5. Greenberger JS, "Results of treatment of 127 patients with systemic histiocytosis", Medicine(Baltimore), 60, pp.311~338 (1981)
  6. Suzuki HI, "Erdheim-Chester disease: multisystem involvement and management with interferon-alpha", Leuk Res, 34, pp.e21~24 (2010)
  7. Breuil V, "Erdheim-Chester disease:typical radiological bone features for a rare xanthogranulomatosis", Ann Rheum Dis, 61, pp.199~200 (2002)
  8. Perlat A, "Erdheim-Chester disease with predominant mesenteric localization:lack of efficacy of interferon alpha", Joint Bone Spine, 76, pp.315~317 (2009)
  9. Haroche J, "Variability in the efficacy of interferon-alpha in Erdheim-Chester disease by patient and site of involvement:results in eight patients", Arthritis Rheum, 54, pp.3330~3336 (2006)

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