Langerhans Cell Histiocytosis - A Rare Case Diagnosed Cytologically

LCH is a rare idiopathic disorder characterized by pathogenic clonal proliferation of bone marrow derived langerhans cells which are immature dendritic cells characterized by presence of Birbeck granules. The annual incidence of LCH is nearly 5.4cases per one million people with male predominance. LCH is primarily a pediatric disease with peak age ranging between 1-4 yrs commonly involving bone. It manifests as single system unifocal, multifocal or multisystem disease. The purpose of this case report is to describe a case of 10 month old male baby with unifocal bone involvement and discuss the clinical, radiological and characteristic cytological features that lead to the diagnosis of LCH.

The Significances of Bony Lesions Observed on MRI of Traumatic Knees / 대한정형외과학회잡지

Diagnosis of trauma to the soft tissue structures of the knee such as menisci, cruciate ligaments, and collateral ligaments has been greatly advanced by MRI. Some bony lesions which couldnt be seen by simple X-rays, also became to be visualized by MRI. The authors reviewed 131 MRI s of traumatized knees from March, 1992 to August, 1995. Among them, various traumatic lesions of bone were found in 62 cases. Those cases were thoroughly reviewed to define the significances of the lesions, by reviewing the medical records and careful examination of simple X-rays and MRI. The bony lesions could be classified into four groups, such as coronal plane injuries (valgus, varus), sagittal plane injuries(contusion of proximal tibia-posterior cruciate ligament injury, patello-femoral contusions), nonspecific direct contusion, and tibial condylar fractures. In the valgus group, 3 components of MRI lesions as the evidences of valgus injury could be observed. They were direct contusions on lateral aspect of the knee, tension failure of medial aspect(medial collateral ligament injury), compression failure of lateral aspect of knee(focal compression lesions of femoral and/or tibial condyle adjacent to lateral meniscus). In other types of injuries, similar findings were observed as evidences of the events at the trauma. Most of the bony lesions were located at the sites where external forces were exerted and/or internal responses took place. It seems that bony lesions seen at MRI of traumatized knee are not simply meaningless, incidental findings but document the events at the time of the trauma.

Bony Lesion of Divers in Korea / 대한정형외과학회잡지

Bornstein and plate (1911) and Bassoe (1913), followed by many European and American, described the radiographic appearance of avascular necrosis of the bone in compressed air worker. Divers bone lesions was described for the first time by Grutzmacher in 1941. There is not any report of information on the caisson disease and divers bone lesions in this country. Inview of these considerations, during the period from March to June 1981, 124 traditional civilian divers and 132 Naval divers, were observed in eight Korean coastal cities (In-cheon, Sam-chun-po, Sin-hae, Pu-san, Ul-san, Ku-ryung-po, joo-moon-jin and Sok-cho). For each divers, a record was made of his medical history, diving experiences and frequencies of bends attacks. The clinical examination included blood pressure, body weight, a chest radiograph and routine checks of the shoulders, hips and knees, but an X-ray examination extended to the spines, ankles, elbows when symptoms existed. The results were as follow: l. Out of 256 divers, 113 (44.2%) had bone lesions, seventy-five traditional divers (60.5%) had bone lesions out of 125 divers, but naval divers, only thirty eight (28.8%) of 132 had such lesions. 2. Divers bone lesion incidence is increased with diving experience especially over 10 years. 3. The most frequent bone lesions occured in the upper end of the humerus, the upper end of the femur, the lower end of the femur and proximal tibia. 4. The most frequent divers bone lesions in X-ray was dense areas (Bl). 5. There was a high incidence (93.1%) in man with a history of the bends and significantly relate between the sites of the bends and those of the lesions. 6. Divers bone lesions incidence was increased with the length of diving experiences, diving depth, diving time, ages and with bends experiences.