giovedì 13 aprile 2006

Vertebral plana due to Langerhan's cell histiocystosis






Findings

Figure 1: Reconstructed sagittal CT scan through the thoracic spine demonstrates a flattened vertebral body. The disk spaces are maintained. The remaining vertebral bodies are unremarkable.
Figure 2: Sagittal T2-weighted MRI demonstrates a focal kyphosis at the level of the flattened vertebral body, with a ventral epidural soft tissue component resulting in thoracic spinal cord compression.
Figure 3: Sagittal T1 post-contrast MRI with fat saturation again demonstrates a focal kyphosis at the level of the flattened vertebral body. The ventral epidural soft tissue component is better demonstrated than on the T2 series

Differential diagnosis for vertebral plana = “MELTS”
- M: Metastasis, myeloma
- E: Ewing’s sarcoma
- L: Langerhan’s cell histiocystosis, leukemia, lymphoma
- T: Trauma, tuberculous osteomyelitis
- S: Steroids


Diagnosis: Vertebral plana due to Langerhan's cell histiocystosis


LCH predominantly affects children and is comprised of three conditions: eosinophilic granuloma, Hand-Schuller-Christian disease, and Letterer-Siwe disease. All three conditions are characterized by the presence of abnormal histiocytes called Langerhan’s cells. Eosinophilic granuloma is the mildest form and is the most common, comprising approximately 70% of the disease. It consists of single or multiple bony lytic lesions, and most commonly involves the skull, mandible, spine, ribs, and long bones. Hand-Schuller-Christian disease (20% of LCH) is a multisystem disease comprised of diabetes insipidus, exopthalmos, and one or multiple bony lesions. It is fatal in approximately 30% of patients. Letterer-Siwe disease (10% of LCH) is the most severe form and it affects children less than three years old with liver, spleen, skin, and bony involvement. It is usually fatal within two years of diagnosis.

Eosinophilic granuloma is a benign condition that has a variable prognosis. Specifically, the prognosis for vertebral plana is favorable. The lesions may regress spontaneously, taking up to two years. The treatment is often conservative, but surgery, radiation, chemotherapy, and steroids may be used if conservative treatment fails.

2 commenti:

  1. I am Sophie from Canada, I once suffered from a terrible and Chronic pineal cyst ,since i was 30 , the doctor told me there was no permanent cure i was given medications to slow down its progress, i constantly felt my health was deteriorating as i constantly go out of breath,and this illness was really terrible especially when am going out with my friends, i have this constant disorder for about 15 years, this was really a terrible ailment ,on thin one day that i was going through the internet,and i came across a post of Mrs Shelley on how his husband was been cured from pineal cyst through the help of Dr Williams herbal product, I contacted this herbal doctor via his email and explain everything to him and make purchase of his product,few days later he sent me the herbal medicine through courier service, when i received the herbal medicine, i used it for 1 months as prescribed by Dr Williams and i was totally cured within those week of usage,on thin now i have not experience any sign or characteristics again . for more information you can email him on drwilliams098675@gmail.com for help

    RispondiElimina
  2. God bless Dr Akhigbe for his marvelous work in my life, I was diagnosed of Herpes Virus since over a month now and I was taking my medications, I wasn't satisfied i needed to get the Herpes virus out of my system, I searched about some possible cure for Herpes i saw a comment about Dr Akhigbe, how he cured Herpes with his herbal medicine, I contacted him and he guided me. I asked for solutions, he started the remedy for my health, he sent me the medicine through UPS SPEED POST. I took the medicine as prescribed by him and 7 days later i was cured from Herpes ,thank you for anyone that may need the medication you can contact him for your urgent cure
    Drakhigbeherbalhome5@gmail.com
    Whats App +2349021374574

    RispondiElimina