Name
Erdheim-Chester disease
ICD-O-3 Morphology
9749/3: Erdheim Chester Disease
Effective
2021 and later
Reportable
for cases diagnosed
2021 and later
Primary Site(s)
No primary site specified
See Module 7
Coding Manual:
Hematopoietic Coding Manual (PDF)
Abstractor Notes
This is a new reportable neoplasm for 2021. If the diagnosis is prior to 1/1/2021, it is not reportable.
Any organ or tissue can be infiltrated by Erdheim-Chester Disease.
Characteristic features on imaging studies are bilateral and symmetrical osteosclerosis of the diaphyseal and metaphyseal parts of the long bones. Osteolytic lesions may also be seen. PET/CT has a high specificity for the diagnosis of bone involvement by ECD.
Erdheim-Chester disease can be mistaken for Langerhans cell histiocytosis. Pathologic confirmation of the disease will need to be done to determine between Langerhans cell histiocytosis and Erdheim-Chester disease.
Although no treatment plans have been established, treatments for this disease include: steroids, immunotherapy, chemotherapy, radiation and surgery.
For more information, see the Histiocytosis Association website (http://www.histio.org/page.aspx?pid=403#.V1cW-UYw0eU)
Any organ or tissue can be infiltrated by Erdheim-Chester Disease.
Characteristic features on imaging studies are bilateral and symmetrical osteosclerosis of the diaphyseal and metaphyseal parts of the long bones. Osteolytic lesions may also be seen. PET/CT has a high specificity for the diagnosis of bone involvement by ECD.
Erdheim-Chester disease can be mistaken for Langerhans cell histiocytosis. Pathologic confirmation of the disease will need to be done to determine between Langerhans cell histiocytosis and Erdheim-Chester disease.
Although no treatment plans have been established, treatments for this disease include: steroids, immunotherapy, chemotherapy, radiation and surgery.
For more information, see the Histiocytosis Association website (http://www.histio.org/page.aspx?pid=403#.V1cW-UYw0eU)
Diagnostic Confirmation
This histology can be determined by positive histology (including peripheral blood) with or without genetics and/or immunophenotyping. Review the Definitive Diagnostic Methods, Immunophenotyping and Genetics Data sections below, and the instructions in the Hematopoietic Manual for further guidance on assigning Diagnostic confirmation.
Grade
Not Applicable
Module Rule
None
Alternate Names
ECD
Lipid (cholesterol) granulomatosis
Lipogranulomatosis
Lipoid granulomatosis
Polyostotic sclerosing histiocytosis
Rosai-Dorfman disease
Definition
Erdheim-Chester disease (ECD) is a clonal systemic proliferation of histiocytes, commonly having a foamy (xanthomatous) component, and contain Touton giant cells (considered to be a non-Langerhans cell histiocytosis).
Definitive Diagnostic Methods
Genetic testing
Histologic confirmation
Immunophenotyping
Genetics Data
Immunophenotyping
CD1a- (no expression/negative)
CD14+ (expression/positive)
CD68+ (expression/positive)
CD163+ (expression/positive)
S100- (no expression/negative)
Treatments
None
Transformations to
There are no known transformations
Transformations from
There are no known transformations
Same Primaries
Corresponding ICD-9 Codes
202.6 Malignant mast cell tumors
Corresponding ICD-10 Codes
C96.2 Malignant mast cell tumor
Corresponding ICD-10-CM Codes (U.S. only)
C96.29 Other malignant mast cell neoplasm (effective October 01, 2015)
Signs and Symptoms
None
Diagnostic Exams
Bone marrow or aspiration and biopsy
Bone scan
BRAF testing
CT (CAT) scan
Immunophenotyping
PET (positron emission tomography) scan
Progression and Transformation
None
Epidemiology and Mortality
Sources
Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J (Eds):
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Histiocytic and dendritic cell neoplasms
Pages: 481-482
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Histiocytic and dendritic cell neoplasms
Pages: 481-482
International Classification of Diseases for Oncology, Third Edition, Second Revision. Geneva: World Health Organization, 2020
Section: ICD-O-3.2 (2020) Morphological Codes
Pages: http://www.iacr.com.fr/index.php?option=com_content&view=category&layout=blog&id=100&Itemid=577
Section: ICD-O-3.2 (2020) Morphological Codes
Pages: http://www.iacr.com.fr/index.php?option=com_content&view=category&layout=blog&id=100&Itemid=577
National Cancer Institute
Section: General Information About Langerhans Cell Histiocytosis (LCH)
Pages: https://www.cancer.gov/types/langerhans/hp/langerhans-treatment-pdq#section/_178%20or%20http://www.cancer.gov/types/langerhans/patient/langerhans-treatment-pdq
Section: General Information About Langerhans Cell Histiocytosis (LCH)
Pages: https://www.cancer.gov/types/langerhans/hp/langerhans-treatment-pdq#section/_178%20or%20http://www.cancer.gov/types/langerhans/patient/langerhans-treatment-pdq