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Coşkun Ç, Kutluk T, Yalçın B, Oğuz B, Orhan D, Yalçın E, Müngen E, Yaman Bajin İ, Özçelik U, Aydın B, Kurucu N, Varan A, Haliloğlu M. Pulmonary involvement in children with Langerhans cell histiocytosis. Turk J Pediatr 2024; 66:323-331. [PMID: 39024603 DOI: 10.24953/turkjpediatr.2024.4515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/20/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Pulmonary Langerhans cell histiocytosis (pLCH) is a rare disease, mostly a component of multisystemic LCH. We aimed to investigate the clinical features and treatment results in children with pLCH. METHODS We retrospectively reviewed the clinical, radiological, and treatment data of 37 patients with pLCH, diagnosed from 1974 to 2022. RESULTS 10% (n=37) of 367 patients with LCH had lung involvement. The median age was 1.8 years (range: 0.4 & 17.7) with a male-to-female ratio of 2.3. At admission 29.7% (n=11) presented with respiratory symptoms. Imaging showed a spectrum from nodular opacities to multiple cysts. All but one patient had multisystem disease. Twenty-nine received vinblastine-containing therapy. Ten-year event-free (EFS) and overall survival (OS) rates were 47.8% and 63.3%, respectively. In children younger and older than two years of age, the 10-year EFS was 53.3% vs. 40.2% and the 10-year OS was 58.7% vs. 68.8%, respectively. In children with and without risk organ involvement, 10-year EFS was 51.9% vs. 46.3% and 10-year OS was 51.9% vs. 73.7%. CONCLUSIONS Lung and multisystem involvement are significant concerns in LCH, highlighting the need for careful management to reduce morbidity and mortality.
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Affiliation(s)
- Çağrı Coşkun
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Tezer Kutluk
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Bilgehan Yalçın
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Berna Oğuz
- Department of Pediatric Radiology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Diclehan Orhan
- Department of Pediatric Pathology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Ebru Yalçın
- Department of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Eren Müngen
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - İnci Yaman Bajin
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Uğur Özçelik
- Department of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Burça Aydın
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Nilgün Kurucu
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Ali Varan
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Mithat Haliloğlu
- Department of Pediatric Radiology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
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Eddin AS, McNeely P, Saad Eldine M, Lai L, Shariftabrizi A. Dural involvement in central nervous system langerhans cells histiocytosis (LCH) on FDG PET/CT: Case report and review of CNS manifestations of LCH on PET/CT. Radiol Case Rep 2024; 19:1391-1396. [PMID: 38268737 PMCID: PMC10803779 DOI: 10.1016/j.radcr.2023.12.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 01/26/2024] Open
Abstract
We report a case of multisystem Langerhans cell histiocytosis in a pediatric patient with central nervous system involvement, highlighting F-18(FDG) uptake characteristics of dural sites of disease. We also highlight the advantages of functional data offered by FDG-PET as a useful follow-up tool to assess viability and, therefore, treatment response of previously known central nervous system lesions. The utility of recognizing characteristic patterns of FDG uptake in dural disease is also applicable in cases of diagnostic uncertainty, such as when evaluating isolated dural lesions or when distinguishing between Langerhans cell histiocytosis and similar appearing lesions such as meningiomas.
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Affiliation(s)
- Assim Saad Eddin
- University of Iowa Hospitals and Clinics; Department of Radiology; Iowa city, IA 52242, USA
| | - Parren McNeely
- University of Iowa Hospitals and Clinics; Department of Radiology; Iowa city, IA 52242, USA
| | - Mothana Saad Eldine
- University of Iowa Hospitals and Clinics; Department of Radiology; Iowa city, IA 52242, USA
| | - Lillian Lai
- University of Iowa Hospitals and Clinics; Department of Radiology; Iowa city, IA 52242, USA
| | - Ahmad Shariftabrizi
- University of Iowa Hospitals and Clinics; Department of Radiology; Iowa city, IA 52242, USA
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Heritier S, Donadieu J, Leger PL, De Tersant M, Della Vallee V, Barkaoui MA, Le Louet S, Tazi A, Taytard J, Corvol H, Helias-Rodzevicz Z, Emile JF, Fadel E, Fabre D, Feuillet S, Nathan N. Lung transplantation as a rescue option in childhood critical pulmonary Langerhans cell histiocytosis. Pediatr Pulmonol 2024; 59:192-195. [PMID: 37792300 DOI: 10.1002/ppul.26717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/11/2023] [Accepted: 09/26/2023] [Indexed: 10/05/2023]
Affiliation(s)
- Sébastien Heritier
- French Reference Center for Histiocytosis, APHP, Trousseau Hospital, Sorbonne Université, Paris, France
| | - Jean Donadieu
- French Reference Center for Histiocytosis, APHP, Trousseau Hospital, Sorbonne Université, Paris, France
| | - Pierre-Louis Leger
- Intensive Care Unit, APHP, Trousseau Hospital, Sorbonne Université, Paris, France
| | - Marie De Tersant
- Department of Pediatric Hematology, Robert-Debré Hospital, Paris, France
| | - Valeria Della Vallee
- Department of Radiology, APHP, Trousseau Hospital, Sorbonne Université, Paris, France
| | - Mohamed-Aziz Barkaoui
- French Reference Center for Histiocytosis, APHP, Trousseau Hospital, Sorbonne Université, Paris, France
| | - Solenne Le Louet
- French Reference Center for Histiocytosis, APHP, Trousseau Hospital, Sorbonne Université, Paris, France
| | - Abdellatif Tazi
- French Reference Center for Histiocytosis, Saint Louis Hospital, Université de Paris, France
| | - Jessica Taytard
- Pediatric Pulmonology Department and Reference Center for Rare Lung Diseases, Inserm UMR_S933, Inserm UMR_S1158, Centre de Recherche Saint Antoine, APHP, Trousseau Hospital, Sorbonne Université, Paris, France
| | - Harriet Corvol
- Pediatric Pulmonology Department and Reference Center for Rare Lung Diseases, Inserm UMR_S933, Inserm UMR_S1158, Centre de Recherche Saint Antoine, APHP, Trousseau Hospital, Sorbonne Université, Paris, France
| | - Zofia Helias-Rodzevicz
- Pathology Department, EA4340-BECCOH, Assistance Publique-Hôpitaux de Paris (APHP), Ambroise-Paré Hospital, Paris-Saclay University, Versailles SQY University (UVSQ), Boulogne, France
| | - Jean-François Emile
- Pathology Department, EA4340-BECCOH, Assistance Publique-Hôpitaux de Paris (APHP), Ambroise-Paré Hospital, Paris-Saclay University, Versailles SQY University (UVSQ), Boulogne, France
| | - Elie Fadel
- Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardio-pulmonaire, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France
| | - Dominique Fabre
- Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardio-pulmonaire, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France
| | - Séverine Feuillet
- Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardio-pulmonaire, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France
| | - Nadia Nathan
- Pediatric Pulmonology Department and Reference Center for Rare Lung Diseases, Inserm UMR_S933, Inserm UMR_S1158, Centre de Recherche Saint Antoine, APHP, Trousseau Hospital, Sorbonne Université, Paris, France
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Advances in Imaging of the ChILD – Childhood Interstitial Lung Disease. Radiol Clin North Am 2022; 60:1003-1020. [DOI: 10.1016/j.rcl.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Luo ZH, Lu PX, Qi WL, Liao FX, Jin AF, Zen QY. Role of 18F-FDG PET/CT in the diagnosis and management of patients with Langerhans cell histiocytosis. Quant Imaging Med Surg 2022; 12:3351-3363. [PMID: 35655814 PMCID: PMC9131337 DOI: 10.21037/qims-21-823] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/04/2022] [Indexed: 03/19/2024]
Abstract
BACKGROUND Langerhans cell histiocytosis (LCH) is an inflammatory myeloid neoplasm that can involve multisystem organs. Positron emission tomography/computed tomography (PET/CT) has been widely used in tumor staging and efficacy evaluation. However, at present, there are few 18F-fluorodeoxyglucose (FDG) PET/CT studies on LCH. This study aimed to explore the possible role of 18F-FDG PET/CT in the diagnosis and management of patients with LCH. METHODS 18F-FDG PET/CT images of 22 Chinese patients diagnosed with LCH on biopsy or surgery histopathology between January 2011 and December 2020 were retrospectively analyzed. The incidence of LCH in each system was assessed by a PET/CT scan. The imaging characteristics were analyzed semiquantitatively and qualitatively. The discrepancies between PET/CT and conventional imaging modalities were recorded. Evaluations of curative effect according to RECIST1.1 and PERCIST1.0 were compared using Fisher's exact chi-squared test, and P values <0.05 were considered significant. RESULTS Eight (36.4%) of the 22 patients presented with single system involvement (4 isolated site involvement, 4 multiple site involvement), and 14 (63.6%) presented with multiple system involvement. Twenty-one (95.5%) patients had hypermetabolic lesions. Musculoskeletal, lymphatic, respiratory, liver, skin-soft tissue and thyroid involvement were seen in 14 (63.6%), 13 (59.1%), 5 (22.7%), 4 (18.2%), 5 (22.7%) and 1 (4.5%) patient, respectively. Cranial and facial bones were the most common sites of musculoskeletal involvement. Ten patients underwent PET/CT follow-up, and there was no significant difference in curative effect evaluations according to RECIST1.1 and PERCIST1.0. However, among the complete remission cases assessed by RECIST1.1, three were partial metabolic responses assessed by PERCIST1.0, while among the partial response cases assessed by RECIST1.1, one was metabolic progressive disease assessed by PERCIST1.0. CONCLUSIONS 18F-FDG PET/CT is an imaging modality option for the diagnosis and assessment of the curative effect of LCH.
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Affiliation(s)
- Zhe-Huang Luo
- PET/CT Center, Jiangxi Provincial People’s Hospital, Nanchang, China
| | - Pu-Xuan Lu
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Wan-Lin Qi
- PET/CT Center, Jiangxi Provincial People’s Hospital, Nanchang, China
| | - Feng-Xiang Liao
- PET/CT Center, Jiangxi Provincial People’s Hospital, Nanchang, China
| | - Ai-Fang Jin
- PET/CT Center, Jiangxi Provincial People’s Hospital, Nanchang, China
| | - Qing-Yun Zen
- PET/CT Center, Jiangxi Provincial People’s Hospital, Nanchang, China
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Wang JN, Wang FD, Sun J, Liang ZY, Li J, Zhou DB, Tian X, Cao XX. Pulmonary manifestations of Erdheim-Chester disease: clinical characteristics, outcomes and comparison with Langerhans cell histiocytosis. Br J Haematol 2021; 194:1024-1033. [PMID: 34423426 DOI: 10.1111/bjh.17712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/30/2021] [Indexed: 01/22/2023]
Abstract
Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis that typically affects many organs, including the lung and pleura. However, there are few studies concerning pulmonary involvement in ECD patients, as well as the difference of pulmonary involvement between ECD and Langerhans cell histiocytosis (LCH). We performed a retrospective study of 54 ECD patients, and compared the pulmonary manifestations with those of adult LCH patients in our centre. The median age of diagnosis of the 54 ECD patients was 48 years (range 9-66 years). Chest computed tomography (CT) scans revealed lung involvement in 49 (91%) patients and pleural involvement in 34 (63%). Thirty-three (61%) patients had interstitial lung disease (ILD) with varying degrees of interlobular septal thickening, micronodules, and ground-glass opacities. ECD and LCH patients with pulmonary involvement showed significant differences in smoking status (P < 0·001), respiratory symptoms (P = 0·001) such as cough and pneumothorax (P < 0·001), and radiological findings, including cysts (P < 0·001), opacities (P < 0·001), and pleural thickening (P < 0·001). With a median follow-up duration of 24 months (range, 1-84 months), the estimated three-year overall survival (OS) of this entire ECD cohort was 90·2%. Patients with ILD tended to have worse progression-free survival (PFS) than those with no ILD (P = 0·29).
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Affiliation(s)
- Ji-Nuo Wang
- Department of Hematology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng-Dan Wang
- Department of Radiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian Sun
- Department of Pathology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhi-Yong Liang
- Department of Pathology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian Li
- Department of Hematology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dao-Bin Zhou
- Department of Hematology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinlun Tian
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin-Xin Cao
- Department of Hematology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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