青少年颈椎嗜酸性肉芽肿一例报告

Cervical spinal eosinophilic granuloma: 1 adolescent case report

骨嗜酸性肉芽肿（eosinophilic granuloma,EG）属于朗格汉斯细胞组织细胞增多症（langerhans cell histiocytosis,LCH）的一种,病因尚不明确,目前认为是原发性免疫缺陷性良性肿瘤样病变。骨EG好发于儿童和青少年,其发病率约占骨肿瘤的1%,而脊柱EG更少见。脊柱EG表现为椎体溶骨性破坏,以单发为主,少数有侵袭性,可侵及椎体附件和周围软组织;其中,胸椎EG发病率最高（54%）,颈椎EG发病率最低（11%）。

Objective To present one adolescent case of cervical spinal eosinophilic granuloma, and to discuss the clinical characteristics, imaging features, differential diagnosis and treatment. Methods An 8-year-old adolescent was admitted to our clinic for neck pain and movement limitation after conservative treatment. Cervical imaging examinations revealed lytic bone lesions involving C_（3-4）, C_（4-5）, C_（5-6） vertebral bodies. Local tenderness was obvious. The biceps brachii muscle strength of the both upper limbs was weakened and the brachial plexus traction test results were positive. Conservative treatment failed. Anterior cervical spine decompression, bone graft fusion and internal fixation were performed. Results No recurrence was detected postoperatively. The internal fixation was removed 1 year postoperatively with satisfactory results. Conclusions Adolescent cervical spinal eosinophilic granuloma is not common and misdiagnosis may occur. Imaging and biopsy are the keys to its diagnosis. Surgical intervention should be considered when the conservative treatment is ineffective or the lesions continue to develop.