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Langerhans cell histiocytosis of the atlas in an adult

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Abstract

Langerhans cell histiocytosis (LCH), formerly known as histiocytosis X, is a rare disorder (approximately 1:1,500,000 inhabitants) characterized by clonal proliferation and excess accumulation of pathologic Langerhans cells causing local or systemic effects. The exact etiology of LCH is still unknown. LCH could affect patients of any age, although most present when they are children. The most frequent sites of the bony lesions are the skull, femur, mandible, pelvis and spine. A variety of treatment modalities has been reported, but there was no evidence suggesting that any one treatment was more advantageous than another. We present an adult with LCH of the atlas. A 26-year-old young man presented with a 2-month history of neck pain and stiffness. CT revealed osteolytic lesion in the left lateral mass of atlas with compression fracture. Histopathological diagnosis was Langerhans cell histiocytosis by percutaneous needle biopsy under CT guidance. The patient underwent conservative treatment, including Halo-vest immobilization and radiotherapy. At 7-year follow-up, the patient was asymptomatic except for mild motion restriction of the neck. CT revealed a significant reconstruction of the C1 lateral mass.

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Authors and Affiliations

  1. Orthopaedic Department, Peking University Third Hospital, No 49, North Garden Street, HaiDian District, 100191, Beijing, China

    Wo Quan Zhong, Liang Jiang, Qing Jun Ma, Zhong Jun Liu, Xiao Guang Liu, Feng Wei & Geng Ting Dang

  2. Radiological Department, Peking University Third Hospital, 100191, Beijing, China

    Hui Shu Yuan

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  1. Wo Quan Zhong
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  2. Liang Jiang
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  3. Qing Jun Ma
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  4. Zhong Jun Liu
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  5. Xiao Guang Liu
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  6. Feng Wei
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  8. Geng Ting Dang
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Correspondence to Liang Jiang.

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Zhong, W.Q., Jiang, L., Ma, Q.J. et al. Langerhans cell histiocytosis of the atlas in an adult. Eur Spine J 19, 19–22 (2010). https://doi.org/10.1007/s00586-009-1172-9

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  • DOI: https://doi.org/10.1007/s00586-009-1172-9

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