脊椎组织细胞增生症X（附21例报告）

Histocytosis X in the Spine: a Report of 21 Cases

１９５５～１９８６年诊治２００余例组织细胞增生症Ｘ，发现脊椎破坏者２１例。发病年龄７个月～１０岁。其中，骨嗜酸性肉芽肿１０例，韩－薛－柯综合征７例，由前者发展成后者３例，介于后者与勒－雪综合征者１例。有８例误诊为脊柱结核。８例做过活组织检查。未经治疗７例中，５例恢复；１１例采用化疗中，１０例进步，１例死亡；３例有神经压迫症状者手术后继续化疗，全部恢复。对其发病情况、临床表现、诊治以及预后进行了讨论。

The authors reported 21 cases of spinal lesion out of 200 cases of histocytosis X in Beijing Children's Hospital from 1955 to 1986. The age of onset ranged from 7 months to 10 years in 13 males and 8 females. According to the pathological classification, 10 were classified as EGB(Eosinophilic Granuloma of Bone) . 7 HSC (Hand-Schuller-Christia), 3 EGB -HSC, 1 HSC- LS (Lettere-Siwe). 8 ca ses were misdiagnosed as spinal tuberculosis. X-ray examination was the main method for diagnosis.Pathological examination was performed on 8 cases. Among 7 cases without treatment, 5 recovered. 1 became worse and 1 lost for following up, 11 cases were treated by chemotherapy, 10 improved in a short period. 1 died.3 cases with neurological dificit had surgical intervention followed by chemotherapy and recovered. The incidence,clinical menifestation, diagnosis, treatment and prognosis were discussed in this paper.