Orbital eosinophilic granuloma

Introduction to eyelid eosinophilic granuloma Histiocytosis X (histiocytosis X) is a lesion caused by a large number of hyperplastic stained tissue cells that accumulate in the eyelids or in various organs, soft tissues and bones. According to the different parts involved, it is divided into local monofocal and systemic multifocal. The younger the age, the more likely it is to develop into a multifocal lesion. The patient is older and more likely to have a single lesion. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: lacrimal gland

Causes of orbital eosinophilic granuloma

(1) Causes of the disease

Unclear pathogenesis may be an immune abnormal disease, especially related to abnormal T lymphocytes. The monoclonal antibody OKT-6 can stain the surface membrane receptor of Langerhans cells.

(two) pathogenesis

The mechanism is not yet clear.

Eyelid eosinophilic granuloma prevention

The usual habits of life are mainly based on diet.

Eyelid eosinophilic granuloma complications Complications lacrimal gland

Different symptoms can occur when granuloma invades the cornea, sclera or uvea.

Orbital eosinophilic granuloma symptoms Common symptoms Granuloma inflammation Cyst sclerosis Histiocytosis

Isolated bone lesions are more common in the skull, followed by the pelvis, spine, ribs and long bones of the extremities. Eosinophilic granuloma can also be multifocal. The frontal and parietal bones of the skull are common lesions. When the humerus is involved, the external hemorrhoids The upper temporal margin is the most common site. Occasionally, the humerus and skull are extensively affected. The lesion is swollen, with tenderness or pain, swelling of the bone, and a new mass of mass above the right eyelid. The upper jaw is swollen, drooping, and the eyeball is protruding. Under the displacement, the lesion occurs in the barrier layer of the bone, breaking through the periosteum, causing inflammation of the lateral soft tissue of the upper eyelid and inflammation of the lacrimal gland. Therefore, the clinical appearance is similar to the appearance of the orbital cyst and lacrimal gland inflammation. Very few lesions may involve the cornea and sclera. And the uvea.

The patient is often a child. In the upper and outer iliac crests and masses, there is tenderness, the possibility of eosinophilic granuloma should be considered. The X-ray photograph shows irregular, jagged osteolytic area, no hardened boundary, CT examination. In addition to the discovery of osteolytic defects, it was also found that the density of soft tissue on the outer side increased, and the local height was high. For such lesions, biopsy should be performed and a large number of histiocytic cells were found. Electron microscopy showed Langerhans particles in the cytoplasm, which was older. The patient can diagnose eosinophilic granuloma.

Eyelid eosinophilic granuloma

1. Immunological examination may find some indicators abnormal.

2. Histopathology of biopsy specimens showed that the most obvious cells were large and lightly stained tissue cells. The nucleus was located in the center of the cell. It was oval, vacuolated, and the nuclear membrane was slightly depressed. Eosinophilic cytoplasm There are more granules. In the background of tissue cell infiltration, different numbers of eosinophils, lymphocytes, plasma cells and multinucleated giant cells can be seen. There are few matrices in the lesion area, but there are many blood vessels, which are easy to bleed, so it can be seen that it contains iron. The macrophage of yellow pigment, the monocytes and multinucleated cells in the old lesions are lipidated, some lesions in the bone can be self-healing, and the lesion area is fibrotic and presents a sclerotic lesion.

Electron microscopy confirmed that the cytoplasm of monocytes has special granules in the cytoplasm, with streaks in the center, open vacuoles at the end, and resembles a racket. It is called a racket body, also known as Birbeck granules or Langerhans granules. Multinucleated giant cells are rich in Mitochondria, smooth endoplasmic reticulum, but no Langangers granules, so Langerhans granules are markers of dendritic tissue cells (Langerhans cells), which are now known to be proliferative of Langerhans cells, a form of skin often present in the cells. The cortex, which explains why tissue cells of eosinophilic granuloma are highly epidermal.

3. X-ray examination of the skull is the best part of the hair, often invading multiple skulls, especially the skull bones, the lesions vary in size, often merged into a large "map-like" bone defect, this performance is quite Characteristics, skull performance mostly from the barrier, with the expansion of the lesion, the internal and external bone plate destruction, local soft tissue uplift swelling, the edge of the bone destruction zone is sharp, usually no hardening, no periosteal reaction is its characteristics, axillary bone Destruction involves the upper edge of the eyelid and the ipsilateral eye.

4. When the ultrasound probes the eyelids, the abnormal echo zone can be detected in the eyelids, the edges are unclear, the shape is irregular, the inner echo is unevenly distributed, the sound attenuation is obvious, the rear boundary is weak or unclear, and the compression is lacking. Sex.

5. CT scan of the tibial bone destruction is osteolytic, clear edge, local soft tissue swelling, can invade the extraocular muscles, lacrimal gland, and even the eyeball, the diaphragm can also be invaded, enhanced CT scan is moderate to obvious enhancement, bone Destruction often occurs in the anterior or anterior humerus, and bone destruction of the squama and tibia can cause eyeballs to protrude.

6. MRI lesions are often located outside the muscle cone, which is characterized by irregular masses. The lesions develop to a certain extent to destroy the sacral wall, invade the axillary fossa or cranial cavity, and invade the intracranial, similar to other cranial sputum communication tumors, but the realm is more It is clear that the T1 weighted image is a medium-low signal, and the T2-weighted image is a medium-high signal. The tumor invades the extraocular muscles, causing it to be compressed, displaced, unclear, and the eyeball is often prominent.

Diagnosis and differentiation of orbital eosinophilic granuloma

In histopathology, there are 2 lesions showing tissue cells, one is "cholesteroma", which occurs in the periorbital bone; the other is giant cell repair granuloma, which does not show histopathology in histopathology. Eosin cells can be distinguished from eosinophilic granuloma, and giant cell repair granuloma shows regional shape, hemorrhage, fibrosis and multinucleated giant cell area, and no eosinophils.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.