Expert's comment concerning Grand Rounds case entitled 'Langerhans cell histiocytosis of the atlas in an adult' (by Wo Quan Zhong, Liang Jiang, Qing Jun Ma, Zhong Jun Liu, Xiao Guang Liu, Feng Wei, Hui Shu Yuan, Geng Ting Dang).

摘要

The authors present a case of Langerhans cell histio-cytosis (LCH) of the atlas vertebra in a 26-year-old patient, and they provide us with an overview of the different presentations of the LCH. A review of the literature regarding the diagnostic workup and also of the different modalities of treatment is included. The pathologic lesion is located at the level of a lateral mass of the atlas vertebra with an obvious loss of height. The X-ray does not clearly show the importance of the lesion while it seems that the lesion is limited to the left lateral mass of atlas, and it causes a potential instability [1,2]. We normally do not use the 3D reconstructions, yet in this specific location at the atlas level it is useful to better define the anatomic involvement. A MRI study is also useful to determine the extension of the lesion both in the soft tissue and also into the spinal canal.