Eosinophilic Granuloma Of The Spine:Case Report And Literature Review

Objective:To stress the clinical manifestation, diagnosis and treatment characteristics of Eosinophilic granuloma with spinal involvement.Methods:A medical records about eosinophilic granuloma with spinal involvement was analyzed retrospectively and the literature was reviewed.Design:Case report.Patient:The patient had thoracic back pain without obvious incentive more than two months before admission, and felt persistent dull pain, activity increased, unease after the break, no significant relationship between the pain and the postural changed. Besides, accompanied by fatigue, anorexia, weight loss, the patient was free of fever and night sweats. The thoracic MRI showed that the thoracic vertebral physiological curvature was poor, T4vertebral morphology become flatten, abnomal bone density.And T1had visible low density shadow. But the intervertebral space wasn’t stenosis.The spine and the soft tissue was not abnormal density of shadow.The rough edges are around the thoracic vertebrae and the facet. Meanwhile, the spinal canal had no significant stenosis, and bilateral vertebral foraminal wasn’t significant stenosis.Diagnosis:the postoperative specimens dyeing under the optical microscope by HE was diagnosed of eosinophilic granuloma.Intervention:Upon completion of the relevant laboratory and imaging tests, the patient was executed by curettage biopsy, bone grafting fusion and internal fixation,and positive nutrition support postoperative.Besides,1course of treatment with low-dose radiation therapy was given.Results:Eosinophilic granuloma of the spine is a rare benign bone tumor-like of self-limiting disease, and is a typical form of LCH lesions. The main clinical manifestation was local pain, activity limitations, kyphosis, local inflammatory reaction and fever.Meanwhlie, vertebral involvement is more common disease damage, as well as "flat vertebral".White blood cells,eosinophil and erythrocyte sedimentation rate are elevated in the Laboratory examinations, and clinical manifestation and laboratory examination are lack of specificity. Diagnosis of Eosinophilic Granuloma of spine relies on pathologic examination.CDla by immunohistochemical staining and S100positive or observed under the electron microscope a diagnostic indication of the significance of Birbeck granules can be diagnosed as EG. Differential diagnosis of Eosinophilic Granuloma of spine included spinal tuberculosis, ischemic necrosis of the vertebral bodies,vertebral metastases,atypical spinal hemangioma, pyogenic spondylitis, spinal giant cell tumor of bone.The teatment of this disease is diverse, and mainly has following several kinds of conservative treatment:fixed lesion of observation, medication, chemotherapy, radiotherapy, hormone injection. If the patient is not valid of the conservative treatment, you should consider surgical intervention.Conclusions:Because of Eosinophilic Granuloma of spine less, and this disease is lack of clear guidelines for the treatment of clinical work and conclusive evidence of effective treatment often leads to misdiagnosis, treatment errors. Selecting the appropriate diagnostic methods and the rignt treatment options could clearly improve the prognosis of patients with eosinophilic granuloma of the spine.