Ümit Akın DERE, A. Memduh KAYMAZ, Ayfer ASLAN

Erişkin Hastada Sakrumun Eozinofilik Granülomu: Ender Yaş ve Lokalizasyonu olan bir Vaka

Eozinofilik granuloma, Langerhans hücreli histiositozis grubundan bir hastalık olan, Histiositozis-X olarak da bilinen, erişkinlere nazaran genellikle çocuk ve adölesanlarda izlenen, kontrolsüz çoğalan histiositlerle karakterize bir rahatsızlıktır. Klinik olarak iyi tanımlanmasına ragmen etyolojik, histolojik ve prognostik faktörler açısından hala netleşmemiş veriler bulunmaktadır. Biz bu olguda eozinofilik granüloması olan erişkin bir hastayı sunuyoruz. Bel ve kalça ağrısı ile kliniğimize başvuran hastaya yapılan incelemelerde sakrumun osteolitik tümörü düşünülerek yapılan cerrahi işlem sonrası alınan doku biyopsisinden yapılan histopatolojik inceleme sonucu eozinofilik granülom olarak gelmiştir. Klinik ve histopatolojik verilerini paylaştığımız bu yazıda amacımız literatürde nadir olarak görülen, erişkin bir hastada rastlanan eozinofilik granülom olgusuyla ilgili klinik tecrübelerimizle literatüere bir katkı sağlamaktır.

Sacral Spine Eosinophilic Granuloma in an Adult Patient: A Case Report of Unusual Age and Location

Eosinophilic granuloma one of a triad of diseases under Langerhans’ cellhistiocytosis as known as Histiocytosis X, is a rare disorder characterized withuncontrolled proliferation of histiocytes, mostly seen among children andadolescents instead of adults. Although the clinical picture is well defined,there are still unclear aspects on etiology, histology and prognosis. Here weare presenting our experiences on a case of eosinophilic granulomainterestingly in an adult patient. She was admitted with back and hip pain.After her diagnosis of sacral spine osteolytic tumor, the biopsy was performedin our clinic and her histopathology was resulted as eosinophilic granuloma. Inthis paper we are presenting the clinical and hystopathological features ofesonophilic granuloma. We aimed to contribute an additional data to theliterature on eosinophilic granuloma presented with an atypical localizationand age. According to current literature, there are only few reports on bothadults and sacrum affected with eosinophilic granuloma.

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Ueda Y, Murakami H, Demura S, Kawahara N, Tomita K, Tsuchiya H. Eosinophilic granuloma of the lumbar spine in an adult. Orthopedics. 2012 Dec;35:e1818-21.
Baillet A 1 , Grange L, Lafaix PA, Gaudin P, Juvin R. Radiculopathy as a manifestation of Langerhans' cell histiocytosis. Joint Bone Spine, 74, 2007;190-3
Bilge T, Barut S, Yaymaci Y, Alatli C. Solitary eosinophilic granuloma of the lumbar spine in an adult. Case report. Paraplegia. 1995;33:485–7
Rimondi E, Mavrogenis AF, Rossi G, Ussia G, Angelini A, Ruggieri P. CT-guided corticosteroid injection for solitary eosinophilic granuloma of the spine. Skeletal Radiol. 2011;40:757-64.
Cañadell J, Villas C, Martinez-Denegri J, Azcarate J, Imizcoz A. Vertebral eosinophilic granuloma. Long-term evolution of a case. Spine (Phila Pa 1976). 1986; 11:767-9.
Reddy PK, Vannemreddy PS, Nanda A. Eosinophilic granuloma of spine in adults: a case report and review of literature. Spinal Cord. 2000; 38:766-8.
Oberman HA. A clinicopathologic study of 40 cases and review of the literature on eosinophilic granuloma of bone. Hand- SchullerChristian disease and Letterer-Siwe disease. Pediatrics. 1961; 28:307-27.
Nakamura H, Nagayama R. Eosinophilic granuloma presenting with local osteolysis in an adult lumbar spine. J Clin Neurosci. 2008; 15:1398-400.
Kumar A. Eosinophilic granuloma of the spine with neurological deficit. Orthopedics. 1990;13:1310–2
Villas C, Martínez-Peric R, Barrios RH, Beguiristain JL. Eosinophilic granuloma of the spine with and without vertebra plana: longterm follow-up ofsix cases. J Spinal Disord. 1993;6:260-8.
Raab P, Hohmann F, Kühl J, Krauspe R. Vertebral remodeling in eosinophilic granuloma of the spine. A long-term follow-up. Spine (Phila Pa 1976), 1998;23:1351-4.
David R, Oria RA, Kumar R, et al. Radiographic features of eosinophilic granuloma of bone. AJR Am J Roentgenol 1989;153:1021–6.
V Y, E SK, S N B, A K, Sekhar MS. Solitary extragnathic langerhans cell histiocytosis - a rare case. J Clin Diagn Res. 2015;9:ZD22-3.
Islinger RB, Kuklo TR, Owens BD, Horan PJ, Choma TJ, Murphey MD, et al. Langerhans cell histiocytosis in patients older than 21 years. Clin Orthop 2000;379:231e5
Sheila W, Maarten E. Langerhans cell histiocytosis: update for the pediatrician. Curr Opin Pediatr. 2008;1:23-9.
Wilner D. Radiology of bone tumors and allied disorders, vol. 2. Philadelphia: Saunders, 1982.