Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Aug 28, 2016; 8(8): 757-763
Published online Aug 28, 2016. doi: 10.4329/wjr.v8.i8.757
Unusual presentation of Erdheim-Chester disease in a child with acute lymphoblastic leukemia
Archana George Vallonthaiel, Asit Ranjan Mridha, Shivanand Gamanagatti, Manisha Jana, Mehar Chand Sharma, Shah Alam Khan, Sameer Bakhshi
Archana George Vallonthaiel, Asit Ranjan Mridha, Mehar Chand Sharma, Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India
Shivanand Gamanagatti, Manisha Jana, Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India
Shah Alam Khan, Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
Sameer Bakhshi, Medical Oncology, All India Institute of Medical Sciences, New Delhi 110029, India
Author contributions: Vallonthaiel AG, Mridha AR and Sharma MC designed the report; Vallonthaiel AG and Mridha AR analyzed the data and wrote the paper; Gamanagatti S, Jana M, Khan SA and Bakhshi S provided the patient’s clinical data.
Institutional review board statement: This case report was exempt from the Institutional Ethics Board standards at All India Institute of Medical Sciences, New Delhi, India.
Informed consent statement: The patient involved in this case report gave her written informed consent authorizing use and disclosure of her protected health information.
Conflict-of-interest statement: None of the authors have any conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Asit Ranjan Mridha, MD, Assistant Professor, Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. asit_aiims@yahoo.co.in
Telephone: +91-11-26593227 Fax: +91-11-26588641
Received: December 15, 2015
Peer-review started: December 18, 2015
First decision: February 29, 2016
Revised: May 14, 2016
Accepted: June 14, 2016
Article in press: June 16, 2016
Published online: August 28, 2016
Abstract

Erdheim-Chester disease (ECD) is an uncommon, non-familial, non-Langerhans cell histiocytosis, which involves skeletal system and soft tissue usually in middle aged and elderly patients. The characteristic radiologic features include bilateral, symmetric cortical osteosclerosis of the diaphyseal and metaphyseal parts of the long bones, or bilateral symmetrically abnormal intense 99mTechnetium labelling of the metaphyseal-diaphyseal region of the long bones, and computed tomography scan findings of “coated aorta” or “hairy kidneys”. ECD in childhood with osteolytic lesion is extremely rare. We describe an unusual case with an expansile lytic bone lesion at presentation in a case of acute lymphoblastic leukemia.

Keywords: Erdheim-Chester disease, Osteolytic lesion, Bone, Acute lymphoblastic leukemia

Core tip: Erdheim-Chester disease (ECD) is characterised by bilateral, symmetric cortical osteosclerosis of the diaphyseal and metaphyseal parts of the long bones. Occurrence of osteolytic lesions and presentation in childhood are extremely rare. We describe an unusual case of ECD with an expansile lytic bone lesion in a case of acute lymphoblastic leukemia.