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J Clin Pathol 57:1225-1228 doi:10.1136/jcp.2004.018481
  • Case report

Erdheim-Chester disease: case report with multisystemic manifestations including testes, thyroid, and lymph nodes, and a review of literature

Table 2

 Differential diagnosis of Erdheim-Chester disease

Diagnosis Affected organs Clinical symptoms Pathology
CNS, central nervous system; GIT, gastrointestinal tract.
Erdheim-Chester disease Bones of lower extremities, CNS, retroperitoneum, lung, heart, liver, spleen, skin, orbit Bone pain, fever, weight loss, weakness, exophthalmos, diabetes insipidus,dysuria, abdominal pain, ataxia, paresis Mononuclear cells, foamy histiocytes (CD68+, CD1a−, S-100−), lymphocytes, Touton giant cells, fibrosis
Neurosarcoidosis Pituitary gland, mostly associated with enlarged hilary lymph nodes Diabetes insipidus, adenopituitary failure, amenorrhoea/galactorrhoea syndrome Epitheloid granulomas with Langhans’ giant cells and lymphocytes
Langerhans’ cell histiocytosis Skin, bones, lymph nodes, ear,gum, lung, GIT, liver, CNS Petechial haemorrhages, erosive and ulcerative lesions, lymphadenopathy,bone pain, fractures, dyspnoea, malabsorption, diabetes insipidus Proliferation of Langerhans cells (CD1a+, S-100+), intracytoplasmic Birbeck granules on electron microscopy
Hypophysitis Adenohypophysis (rarely neurohypophysis) Headache, diabetes insipidus, amenorrhoea/galactorrhoea syndrome Common finding: lymphoplasmocytic infiltration with focal or diffuse destruction
    Lymphocytic
    Granulomatous
    Xanthomatous
    Xanthogranulomatous
    Necrotising

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