Table 3.

Erdheim-Chester disease diagnostic criteria23 

Clinical or morphological 
1. Symmetric diaphyseal and metaphyseal osteosclerosis in the legs; best seen by PET scan 
2. Other typical ECD findings: perirenal infiltration or periaortic sheathing (CT), right atrial pseudotumor (MRI), or physical examination findings of xanthelasma, exophthalmos, or osteosclerosis of facial sinuses 
Histopathological 
1. Foamy or lipid-laden histiocytes, fibrosis, and sometimes Touton giant cells 
2. Staining for CD68 or CD163 and negative for CD1a 
Molecular 
1. BRAFV600E mutation 
2. Other activating mutations of the MAPK pathway: KRAS, NRAS, MaP2K1, ARAF, MAP3KI, and others 
3. Gene fusion activating the MAPK pathway or 
4. Activating mutation in CSF1R 
Clinical or morphological 
1. Symmetric diaphyseal and metaphyseal osteosclerosis in the legs; best seen by PET scan 
2. Other typical ECD findings: perirenal infiltration or periaortic sheathing (CT), right atrial pseudotumor (MRI), or physical examination findings of xanthelasma, exophthalmos, or osteosclerosis of facial sinuses 
Histopathological 
1. Foamy or lipid-laden histiocytes, fibrosis, and sometimes Touton giant cells 
2. Staining for CD68 or CD163 and negative for CD1a 
Molecular 
1. BRAFV600E mutation 
2. Other activating mutations of the MAPK pathway: KRAS, NRAS, MaP2K1, ARAF, MAP3KI, and others 
3. Gene fusion activating the MAPK pathway or 
4. Activating mutation in CSF1R 
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