EOZINOFYLNY GRANULOMA KOSTYA (eosine - f-Greek philia love, tendency; granuloma; a synonym Taratynov's disease) — the disease which is characterized by existence in bones of the infiltrates consisting of gnstiotsitarny elements, eosinophils, leukocytes, and also neutrophils, lymphocytes and plasmocytes.
For the first time the disease was described Kazan the pathologist of m by N. I. Taratynov in 1913 as the pseudotuberculous granuloma of not clear etiology arising after an injury.
In the 30th 20 century are defeat was mentioned under the names «eosinophilic myeloma» and «osteomyelitis with eosinophilic reaction»; in the 40th there was a term «solitary granuloma of a bone», and in 1944 to Jaffa (H. L. Jaffe) and L. Likhtenstayn offered the name «eosinophilic granuloma of a bone».
The etiology is not known. On the basis of detection in cells of virus-like inclusions suggest about a virus etiology E. to. Some researchers, considering cellular - nevuyu structure, a favorable effect at introduction of corticosteroids and antibiotics, consider that development E. to. it is caused by allergic processes.
In a crust, time E. to. consider as one of options of gistio-ditoz of X (see Gisgpiotsitoza), to the Crimea carry also Hend's disease — Schueller — Krischena (see Hend — Iiiyullera — Krischena a disease) and Letterer's disease — Siwa (see Letterer — Siwa a disease).
Clinical to and r t and - N and. More than in half of cases E. to. occurs at children from 1 to 15 years, is more often at the age of 5 — 10 years. In 70 — 80% of cases defeat has solitary character. As a rule, AA. to. it is localized in bones of a skull, long tubular bones (femoral and humeral), can meet in vertebrae and pelvic bones. At multiple defeat the centers are noted in various departments of a skeleton. Usually the disease is shown by pain in a zone of defeat, a swelling or formation of an opukholepodobny node (especially at localization in a skull). In some cases it is possible to find poorly expressed eosinophilia (see).
The diagnosis is established presumably on the basis by a wedge, pictures, data rentgenol. researches, and finally by results morfol. researches of the material received at a biopsy, a curettage or at a puncture of the affected bone (see. Eosinophilic granuloma). At rentgenol. a research the centers of destruction in bones of a calvaria, edges, haunch bones are noted, especially in nadvertluzh-ache areas and in proximal departments of femurs. Osteoli-tichesky process in a bone has a number of idiosyncrasies: the destructive focus which is coming to light in the beginning in spongy substance quickly passes to compact substance of a bone, often causing its perforation. Defects of a bone have the rounded, ovoid or irregular form. Merging among themselves further, they get accurately outlined polycyclic contours. Defects of bone substance keep the remains of bone crossbeams and have clearly the expressed cellular character. The reactive sclerosis of edges of defects is absent or is poorly expressed. The noticeable thickening of a layer of compact substance is not noted, periostoses are absent. The involute current up to self-liquidation can be observed patol. the center, to-ry within
2 — 3 years it is replaced with a bone tissue. AA. to. can become complicated patol. a change, at the same time the reparation of bone fragments comes timely.
At localization of the centers in bones of a skull there can be accurately outlined centers of destruction in spongy substance of a bone, in internal and outside plates of compact substance. In the center of the centers sometimes it is possible to see bone sequesters. Seams of a skull do not interfere with transition of process from one bone of a skull to another.
At rentgenol. a research the eosinophilic granuloma of a body of a vertebra is similar to an osteochondropathy of a body of a vertebra (see fig. to the Art. to Kaljva a disease, t. 10, p. 46). Destruction of a vertebra an eosinophilic granuloma involves patol. a change with formation of a wedge-shaped or flat vertebra with the subsequent complete or partial recovery of its form and structure.
Differential diagnosis is carried out with atypical forms of osteomyelitis (see), tuberculosis of bones (see Tuberculosis extra pulmonary), an osteoblastoclastoma (see), a myeloma (see. Multiple myeloma), a xanthomatosis (see).
Treatment in most cases at the single center of defeat operational (a curettage, sometimes a partial resection of a bone). Sometimes it is combined with radiation therapy. At multiple defeat use chemotherapy in a combination with corticosteroids, beam and operational treatment.
The forecast at solitary E. to., as a rule, favorable. Bibliography: Alekseev G. A. and Le
of wine D. A. O diffusion option of an eosinophilic granuloma of bones (Taratynov's disease), Haematologia, kot. 2, old. 355, 1968; Vinogradova T. P. Tumors of bones, page 284, M., 1973; Mos-to and h e in and K. A., Nebolsin L. I. and Znamenskaya I. V. Retikulo-gistiotsitoz at children, page 62, L., 1967; N the island and to about in and AA. 3. Radiological changes at diseases of system of a kro-za, M., 1982; Pathological anatomy
of diseases of a fruit and the child, under the editorship of T. E. Ivanovo and B. S. Gusman, t. 1, page 193, M., 1981; Reynberg S.A. Radiodiagnosis of diseases of bones and joints, book 1, page 497, M., 1964; T and-ger I. L. and Dyachenko V. A. Radiodiagnosis of diseases of a backbone, page 303, M., 1971; T and r and t of y-N about in N. I. K to a question of communication of a local eosinophilia with education in fabrics of crystals (Charcot — Leyden’a), Ka-zansk. medical zhurn., t. 13, No. 1,
page 39, 1913; Gaffey J. Pediatric X-ray diagnosis, Amer. J. Roentgenol., v. 100, p. 81, 1967; Lichtenstein L. Histiocytosis X, Integration of eosinophilic granuloma of bone, Arch. Path., v. 56, p. 84, 1953; it, Bone tumors, p. 415, St Louis, 1977; Motoi M. o. Eosinophilic granuloma of lymph nodes, Histo-pathology, v. 4, p. 585, 1980; Pathology, ed. by W. A. D. Anderson a. J. M. Kissane, v. 2, p. 1106, 1284, St Louis, 1977;
Roentgenology of the lymphomas and leu-kemias, ed. by B. Felson, N. Y., 1980;
Whitehouse G. H. Histiocytosis X, radiological bone changes, Proc. roy. Soc. Med., v. 64, p. 333, 1971.
Yu» H. Nightingales; AA. 3. Novikova (rents.) .,