Posterior pedicle screw fixation combined with local steroid injections for treating axial eosinophilic granulomas and atlantoaxial dislocation:A case report

BACKGROUND Eosinophilic granuloma(EG)is a proliferative condition that affects the cells of bone tissue.There are no specific clinical signs or imaging manifestations in the early stages of the disease,making it simple to overlook and misdiagnose.Because of the disease's rarity,there is presently no standardized treatment principle.There are few accounts of such occurrences affecting the axis among children.We discovered a case of a child whose EG resulted in atlantoaxial joint dislocation and destruction of the axial bone.CASE SUMMARY After having pharyngeal discomfort for more than six months without a clear explanation,a 6-year-old boy was brought to our hospital.Following a careful evaluation,the pathology indicated a strong likelihood of an axial EG.Ultimately,we decided to treat the boy with posterior pedicle screw fixation and local steroid injections.CONCLUSION EGs of the upper cervical spine are quite uncommon in children,and they are exceedingly easy to overlook or misdiagnose.Posterior pedicle screw fixation and local steroid injections are effective treatments for patients with axial EGs affecting the atlantoaxial junction.

Endoscopic findings and pathologic characteristics of gastric eosinophilic granuloma:A report of 18 patients

AIM: To investigate the endoscopic findings and patholo- gic characteristics of gastric eosinophilic granuloma (GEG). METHODS: A retrospective study of 18 cases of gastric eosinophilic granulomas was conducted. Gastroscopy was performed and all specimens of biopsies were stained by H&E and observed under light microscopy. RESULTS: Ulcer was the most frequent endoscopic appearance. The others included deformed pylorus and/or duodenal bulb, esophagitis, mucous hyperemia and/or mucosal erosion. Eosinophilic cell infiltration and generous hyperplasia of arterioles, venules and lymph vessels were found in the lesions of the patients. Interstitium had massive eosinophilic infiltrates and was made up of collagen fibers and fibroblasts. Lymphoid follicles were revealed in some sections of biopsies. CONCLUSION: GEG is lack of specific symptoms and physical signs. It can be misdiagnosed as gastric ulcer in most cases before biopsies. Endoscopy and endoscopic multiple deep biopsies in suspected areas are indispensable for correct diagnosis of GEG.

Primary Hodgkin disease of the spine could mimic eosinophilic granuloma initially

Primary Hodgkin disease （HD） of bone is rare. The recognition on it is relatively confined. Bothcases arising-in male adults were suspected to be Potts disease （spinal tuberculosis） on imaging, and pathologic misdiagnosed initially. The clinical situations rapidly aggravated. The pathomorphology was remarkable malignant changed. They shared similar process in clinical, radiological and diagnostic process and could be representative. We retrospectively analyzed correlative results of them and review points of distinction from other disease entities that might be confused with it.

Eosinophilic gastroenteritis in basset hound dog

An 1-year-old male Basset Hound dog was evaluated for chronic intermittent vomiting, hematemesis, and melena which had been ongoing for several months. The histopathologic examination revealed that all layers of the small intestine were thicker than normal. The lamina propria of the mucosa, including the villi, exhibited a prominent cellular infiltrate which consisted of numerous eosinophils and an increased numbers of plasma cells in addition to the normal lymphocytic component. The muscularis mucosa was invaded, and in some places disrupted, by eosinophils, which also infiltrated into the submucosa and muscularis propria. This report describes the pathological findings of a case of eosinophilic gastroenteritis (EG) in a dog.

A rare case of langerhans cell histiocytosis of the gastrointestinal tract

Langerhans cell histiocytosis （LCH） is a group of idiopathic disorders characterized by the proliferation of specialized, bone marrow-derived langerhans cells and mature eosinophils. The clinical spectrum ranges from an acute, fulminant, disseminated disease called Letterer Siwe disease to solitary or few, indolent and chronic lesions of the bone or other organs called eosinophilic granuloma. Involvement of the gastrointestinal tract is very rare in LCH. We present the case of a 53-year-old woman referred by her primary care physician for a screening colonoscopy. A single sessile polyp, measuring 4 mm in size, was found in the rectum. Histopathological examination revealed that the lesion was relatively well circumscribed and comprised mainly a mixture of polygonal cells with moderate-to-abundant pink slightly granular cytoplasm. The nuclei within these cells had frequent grooves and were occasionally folded. Immunohistochemical staining was positive for CD la which confirmed the diagnosis of LCH. On further workup, there was no evidence of involvement of any other organ. On follow up colonoscopy one year later, there was no evidence of disease recurrence. Review of the published literature revealed that LCH presenting as solitary colonic polyp is rare. However, with the increasing rates of screening colonoscopy, more colonic polyps may be identified as LCH on histopathology. This underscores the importance of recognizing this rare condition and ensuring proper follow-up to rule out systemic disease.

Bone analysis using an aggregation-induced emission-active iridium complex

Fluorescent analysis of bone provides valuable insights into bone structures.However,conventional dyes suffer from low specificity on bone tissue,small stokes shift,short fluorescent lifetime,and aggregation-caused quenching effect,which result in low efficacy and artifacts.In this work,we design an aggregation-induced emission(AIE)-active iridium(III)complex(Ir-BP2)as a highly selective,convenient,nondestructiveness,and dual-mode staining agent for bone analysis.Ir-BP2 containing phosphonate groups selectively binds to hydroxyapatites,the main component of bone matrix,and exhibits turn-on AIE phosphorescence with prolonged lifetime.Ir-BP2 exhibits promising biosafety and offers higher accuracy in staining calcium deposits than conventional Alizarin Red S staining assay when it is employed in real-time monitoring of osteogenesis differentiation process.A ready-to-use staining spray of Ir-BP2 is fabricated.By using fluorescent imaging and lifetime imaging,Ir-BP2 staining provides valuable insights into bone microstructure analysis,microdamage diagnosis,and bone growth state identification.Further,Ir-BP2 is successfully applied on a human spine vertebra for diagnosing bone invasiveness of eosinophilic granuloma,validating its clinical practice.This work presents a powerful tool in bone analysis and will lead to new approaches for the diagnosis and treatment of bone-related diseases.