ABSTRACT
A 19-year-old Thai man presented with symptoms of central diabetes insipidus, exopthalmos and multiple ostolytic lesions of the cranial vault. Skin biopsy showed strongly positive CD 1a and S100. Electron microscopy showed rod shape and pentalaminar granules called "Birbeck" granules, a diagnosis compatible with Langerhans' cell histiocytosis (LCHs) or histiocytosis X. He was successfully treated with systemic chemotherapy.
Subject(s)
Diabetes Insipidus, Neurogenic/etiology , Histiocytosis, Langerhans-Cell/complications , Antineoplastic Agents/administration & dosage , Biopsy , Diagnosis, Differential , Drug Therapy , Histiocytosis, Langerhans-Cell/drug therapy , Histiocytosis, Langerhans-Cell/pathology , Humans , Magnetic Resonance Spectroscopy , Male , Prednisolone/administration & dosage , Treatment Outcome , Vinblastine/administration & dosage , Young AdultABSTRACT
OBJECTIVE: Determine MRI features to differentiate between benign and malignant lesions. MATERIAL AND METHOD: The Magnetic resonance imaging (MRI) taken in the 5-year period (2003-2007) of 85 patients with benign and malignant soft tissue masses were analyzed. The criteria for discrimination were based on size, origin, signal homogeneity on T1- and T2-weighted, perilesional edema or invasion, hemorrhage, necrosis, and bone and neurovascular involvements. RESULT: There were 50 benign and 35 malignant lesions. Eighty-two lesions had histologic proof while three lesions had MRI characteristics of benign lipoma. CONCLUSION: No single MRI feature was diagnostic for any soft tissue tumors in the present study. However, three individual MRI features were statistically significant for differentiation between benign and malignant soft tissue masses (p < 0.05). The features that favor malignancy were heterogeneous signal on T2-weighted, perilesional edema or invasion, and necrosis in the masses.
