Eosinophilic granuloma of bone
Introduction
Introduction to bone eosinophilic granuloma Bone eosinophilic granuloma generally refers to tissue cell proliferative disease that is restricted to bone and belongs to a type of histiocytosis. Osteolytic lesions contain accumulation of tissue cells and eosinophils. The age of predilection is adolescents. The most common sites are skull, ribs, spine, and scapula. Long bone lesions are more common in the metaphysis and the backbone. Pain and swelling are the main symptoms that can cause pathological fractures, and most patients see a pathological fracture. In the case of collapse after vertebral body destruction, spinal cord or nerve root compression symptoms may occur in some cases. Osteolytic lesions contain accumulation of tissue cells and eosinophils. basic knowledge The proportion of sickness: 0.004% - 0.006% Susceptible people: occur in men under the age of 30, more than 5 to 10 years old Mode of infection: non-infectious Complications: fracture
Cause
Cause of bone eosinophilic granuloma
Immunity factor (30%):
The etiology of bone eosinophilic granuloma is not well defined and may be responsible for the proliferation of reactive tissue cells of certain allergens, parasites or foreign bodies or for an immune response to an unknown allergen. The diseased tissue is granulation tissue, soft and brittle, but also slightly tough, marginal bone sclerosis. Microscopically, there are abundant hyperplastic capillaries, many tissue cells and eosinophils, and there are different degrees of hemorrhage and necrosis.
Pathogenesis:
The lesion is located in the medullary cavity as a granulation-like tissue. The cut surface is gray, gray-red or yellow, soft and brittle. The edge of the localized bone destruction has osteosclerosis. The microscopic observation of the matrix consists of a network surrounded by small cell populations or single cells. The tissue structure surrounds a wide intercellular network of cells, containing varying amounts of eosinophils. In areas where the tissue is dense and parenchymal, there are fewer eosinophils and more eosinophils. The distribution area, in addition to more eosinophils, and the common number of lymphocytes, plasma cells and foam cells.
Prevention
Bone eosinophilic granuloma prevention
1, eat more high-calcium food,
2, to increase the intake of multivitamins, such as vitamins A, B1, B6, B12, C and D.
3, should eat more vegetables, fruits and food containing crude fiber, eat nuts, pay attention to nutritional supplements. Eat a diet rich in antioxidants such as mango, papaya, melon, grapes, oranges, pineapples, bananas, strawberries, tomatoes, cabbage, potatoes, etc.
Complication
Bone eosinophilic granuloma complications Complications
It can cause pathological fractures, and collapse after vertebral body destruction. In some cases, spinal cord or nerve root compression symptoms may occur.
Symptom
Symptoms of bone eosinophilic granuloma Common symptoms Spinal cord compression granuloma grows slowly
It can occur from infant to old age. Most patients are males under the age of 30, with more than 5 to 10 years old.
The clinical symptoms vary greatly, generally the incidence is slow, the incidence is occult, there may be a long history before the symptoms occur, some only mild pain, the dysfunction of the affected part, the swelling in the superficial part is obvious, each bone It can touch bone changes, long bones are hypertrophy, a wide range of skull destruction, hand touch can touch bone depression, lesions located in the spine can be complicated by lateral curvature or kyphosis, activity is limited, and a few can occur after pathological fracture Spinal cord compression symptoms.
Examine
Examination of bone eosinophilic granuloma
Blood routine: White blood cells and eosinophils can be moderately increased, but not common.
X-ray examination: for osteolytic changes with isolated boundaries, the lesions in the skull due to the location of the disease are localized bone destruction, which may be single or multiple, the skull and the outer and outer plates are damaged, and the edges are sharp. Bending, the lesion of the scapula is a sharp edge with obvious bone destruction.
Imaging examination: Collapse after vertebral body destruction, the vertebral body upper and lower tarsal plates are merged together, there is no abnormality in the intervertebral space, and the long bone lesion is osteolytic destruction, so that it expands outward into an irregular shape with clear boundaries, but rarely There is a thin layer of hard edges. This radioactive image appears only in the less active and relatively old lesions. The lesions are less invasive and have obvious repair phenomena around the bone. After perforating the cortical bone, the periosteum is reactive. The bone is attached to the surface of the cortical bone in a layered manner, and some may cause pathological fractures.
Diagnosis
Diagnosis and differentiation of bone eosinophilic granuloma
Diagnosis: The disease occurs in adolescents, with fewer adults. Adolescents and children with mild pain in the affected area, sharp-edged osteolytic lesions on the X-ray film, irregular new bone, increased total white blood cell count and eosinophil count should be considered.
Differential diagnosis: Single disease patients should be differentiated from Ewing sarcoma, chronic osteomyelitis and bone tuberculosis; multiple bone disease should be differentiated from multiple myeloma and bone metastases.
