Xanthogranulomatous osteomyelitis
| Xanthogranulomatous osteomyelitis | |
|---|---|
| Other names | XO |
| Specialty | Infectious disease, orthopedic |
Xanthogranulomatous osteomyelitis is a peculiar aspect of osteomyelitis characterized by prevalent histiocytic infiltrate and foamy macrophage clustering.[1]
Pathology
[edit]The granulomatous tissue largely comprises foam cells of monocyte/macrophage origin positive for KP1, HAM56, CD11b and CD68. Neutrophils, hemorrhagic foci and numerous plasma cells are additional findings.[2][3][4][5] Staphylococcus aureus was isolated in the case reported by Kamat et al.[5] A delayed type hypersensitivity reaction in cell-mediated immunity has been suggested in this type of infiltrate that is composed of macrophages and T cells.[3] T cells are represented by a mixture of CD4+ and CD8+ lymphocytes. Macrophages and lymphocytes show marked expression of HLA-DR antigen.[6] Arguably XO is the bone localization of the xanthogranulomatous process occurring in several other locations.[2]
Diagnosis
[edit]As of 2011 five cases had been reported, involving rib, tibial epiphysis, ulna, distal tibia and femur. Young individuals are prevalently affected but one case involved a 50-year-old woman. Pain, swelling of possibly long duration, fever and increased ESR are some of the main clinical findings. X-ray examination shows lytic foci with sclerotic margins.[2][3][4][5]
Management
[edit]Antibiotics have been used with success for cases with positive cultures, Curettage, bone grafting, and resection has been described in few studies.[7][8]
References
[edit]- ^ Rosai J (2004). Rosai and Ackerman's Surgical Pathology. Philadelphia: Mosby. p. 2142.
- ^ a b c Cozzutto C (December 1984). "Xanthogranulomatous osteomyelitis". Archives of Pathology & Laboratory Medicine. 108 (12): 973–6. PMID 6334505.
- ^ a b c Vankalakunti M, Saikia UN, Mathew M, Kang M (April 2007). "Xanthogranulomatous osteomyelitis of ulna mimicking neoplasm". World Journal of Surgical Oncology. 5: 46. doi:10.1186/1477-7819-5-46. PMC 1865539. PMID 17470270.
- ^ a b Kashani MM, Zakerian BZ, Shayan K, Riyasi F (2010). "Xanthogranulomatous osteomyelitis of femur" (PDF). Iran J Orthop Surg. 8 (4): 187–190.
- ^ a b c Kamat G, Gramapurohit V, Myageri A, Shettar C (2011). "Xanthogranulomatous osteomyelitis presenting as swelling in right tibia". Case Reports in Pathology. 2011: 257458. doi:10.1155/2011/257458. PMC 3420650. PMID 22937381.
- ^ Nakashiro H, Haraoka S, Fujiwara K, Harada S, Hisatsugu T, Watanabe T (November 1995). "Xanthogranulomatous cholecystis. Cell composition and a possible pathogenetic role of cell-mediated immunity". Pathology, Research and Practice. 191 (11): 1078–86. doi:10.1016/S0344-0338(11)80651-5. PMID 8822108.
- ^ Pathak S, Gautam R, Pc P, Bagtharia P, Sharma A (October 2019). "A Rare Case Report on Xanthogranulomatous Osteomyelitis of Hip Mimicking Tuberculosis and Review of Literature". Cureus. 11 (10): e5921. doi:10.7759/cureus.5921. PMC 6857822. PMID 31788379.
- ^ Sapra R, Jain P, Gupta S, Kumar R (2015). "Multifocal bilateral xanthogranulomatous osteomyelitis". Indian Journal of Orthopaedics. 49 (4): 482–4. doi:10.4103/0019-5413.159682. PMC 4510806. PMID 26229173.