“ This is a disease of immune regulation resulting in excessive histiocytes and granuloma formation . Eosinophilic granuloma is the term giv...
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This is a disease of immune regulation resulting in excessive histiocytes and granuloma formation. Eosinophilic granuloma is the term given to Langerhans cell histiocytosis localised to either the bone or lung. It is a monostotic disease affecting young children (5-10 years of age). Patients present with pain and a mass, and back pain or scoliosis if there is spinal involvement.
SKULL X-RAY
• 50% involve the skull (25% axial skeleton).
• Well-defined lytic lesion, ‘punched out’ of the parietal or temporal bone.
• The edges of the lesion have a scalloped appearance.
• The lytic lesion is associated with a soft tissue mass.
SPINE X-RAY
• Complete collapse (vertebra plana) of a thoracic spine vertebral body.
• Posterior elements rarely involved.
• No kyphosis, disc spaces normal.
• Eosinophilic granuloma/Langerhans cell histiocytosis is the most common cause of vertebral collapse in children.
APPENDICULAR X-RAY
• Affects the diaphysis.
• Well-defined lucency ‘punched out’ from the bone medulla.
• Surrounded by dense sclerosis and mature periosteal new bone.
CT
• Shows a soft tissue mass enhancing within the area of bone lysis.
MRI
• Soft tissue mass is high signal on T1 due to histiocyte content.
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