框架立体定向活检术在中枢神经系统朗格汉斯细胞组织细胞增生症的诊断价值

The value of frame-based stereotactic biopsy in the diagnosis of Langerhans cell histiocytosis of the central nervous system

目的探讨框架立体定向活检术在中枢神经系统朗格汉斯细胞组织细胞增生症(Langerhans cell histiocytosis,LCH)的作用。方法回顾性分析14例拟诊中枢神经系统LCH病例资料。14例病人均行框架立体定向活检术,且活检靶点选取和穿刺路径设计均在三维可视化图像重建规划软件辅助下完成。结果14例病人病理诊断均为LCH,活检阳性率100%。术中针道少量出血2例,未见手术相关新发内分泌缺陷与神经功能障碍病例,无手术相关死亡病例。结论采用框架立体定向活检术安全可靠、手术并发症少且诊断率高。组织病理学、免疫组化及分子生物学特征的明确,有助于对LCH的进一步认识。

Objective To investigate the role of frame-based stereotactic biopsy in Langerhans cell histiocytosis(LCH)in the central nervous system.Methods Clinical data of 14 patients with central nervous system LCH were analyzed retrospectively.All of the patients underwent frame-based stereotactic biopsy,and the selection of biopsy targets and the design of puncture trajectory were performed by 3 D visualization image reconstruction planning software.Results The pathological diagnosis of all the 14 patients was LCH,and the positivity rate of biopsy was 100%.There were 2 cases of minor bleeding in the needle way during the operation,no new cases of endocrine defects and neurological dysfunction related to the operation,and no deaths related to the operation.Conclusions Frame-based stereotactic biopsy is safe and reliable,with few surgical complications and a high diagnosis rate.The definite characteristics of histopathology,immunohistochemistry and molecular biology are helpful for further understanding of LCH.