Abstract
Materials and Methods
From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively.
Results
A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow‐up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3‐6 months observation, intralesional steroid injection was performed.
Conclusion
Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3‐6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.
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Figure 1.
Lateral view of LCH in the cervical spine. Kyphotic deformity was seen at initial view (Left). After ILSI patient recover the normal curvature (right).
![jkbjts-20-14f1.tif](/upload/SynapseXML/0164jkbjts/thumb/jkbjts-20-14f1.gif)
Figure 3.
AP view of LCH in the right humeral shaft area. Osteolytic lesion and periosteal reaction was seen. (Left) After surgical biopsy simple observation was applied. 8 months after the observation bone healing with sclerosis was seen.
![jkbjts-20-14f3.tif](/upload/SynapseXML/0164jkbjts/thumb/jkbjts-20-14f3.gif)
Figure 4.
LCH lesion with pathologic fracture at right proximal humerus. 11 month after operation with TENs bone union was acquired.
![jkbjts-20-14f4.tif](/upload/SynapseXML/0164jkbjts/thumb/jkbjts-20-14f4.gif)
Table 1.
Langerhans Cell Histiocytosis: Clinical Types and Categorization Schemes9)
Table 2.
Patient's Characteristics