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目的探讨下颌骨朗格汉斯细胞组织细胞增多症(Langerhans cell histiocytosis,LCH)的影像表现和病理特征。方法回顾性分析经病理证实的2例下颌骨LCH患者的影像及临床病理资料,并复习相关文献。结果2例病灶均位于下颌骨升支,其中1例累及下颌角。下颌骨骨质呈溶骨性及膨胀性破坏并见周围软组织肿块。病灶边界清晰,密度不均匀,内见低密度囊变坏死区;增强扫描后呈轻中度不均匀强化。病理示2例病灶内均含有丰富的朗格汉斯细胞组织细胞,见散在嗜酸性粒细胞浸润;免疫组织化学示CD1a、S-100及CD68呈阳性。结论下颌骨LCH的影像学表现虽然缺乏特征性,但发生于小儿患者下颌骨升支溶骨性及膨胀性的肿块应考虑该病。确诊仍需结合病理学及免疫组织化学检查。
Objective To investigate the imaging and pathological features of Langerhans cell histiocytosis (LCH) in the mandible. Methods We retrospectively analyzed the imaging and clinicopathological data of 2 cases of mandibular LCH confirmed by pathology and reviewed the related literatures. Results Two lesions were located in the ascending branch of the mandible, one of them involving the mandibular angle. Mandible osteolytic and expansive destruction of bone and see the surrounding soft tissue mass. Clear boundary of the lesion, the density is uneven, see the low-density cystic degeneration area; enhanced scan was mild to moderate non-uniform enhancement. Pathology showed two cases of lesions are rich in Langerhans cells, scattered in eosinophil infiltration; immunohistochemistry showed CD1a, S-100 and CD68 positive. Conclusions The imaging features of LCH in mandible, although lacking in characteristic features, should be considered in lumps with osteolytic and expansive ascending branches in pediatric patients. Confirmed still need to combine pathology and immunohistochemistry.