Title

Multifocal Langerhans Cell Histiocytosis in an Adult

UMMS Affiliation

Department of Radiology; Department of Pathology; Department of Orthopedics and Physical Rehabilitation

Date

12-1-2015

Document Type

Article

Disciplines

Hemic and Lymphatic Diseases | Pathology | Radiology

Abstract

Eosinophilic granuloma (EG) is the most common and benign form of the spectrum of disorders referred to as Langerhans cell histiocytosis (LCH). Langerhans cell histiocytosis is primarily regarded as a pediatric disease, with few adult cases of multifocal EG of bone reported. We report a case of multifocal EG in a 48-year-old woman, who presented with right knee pain. Radiographs showed a small lytic lesion in the medial femoral condyle. Diagnosis was confirmed by ultrasound-guided biopsy. She had had a previous EG lesion excised from her skull. Whole-body bone scan demonstrated a new skull lesion in the right diploic space, which was confirmed by magnetic resonance imaging. The patient underwent curettage, bone grafting, and prophylactic internal fixation of the right distal femur lesion. The skull lesion was treated with repeat craniectomy. Two years later, she developed a new lesion in the right distal femoral metaphysis, which was treated with intralesional corticosteroid injections. Now, more than 1 year later, the patient is pain-free with no evidence of new or recurrent disease. Because multifocal EG is a rare diagnosis in adults, appropriate clinical suspicion, in combination with radiographic findings and histologic examination, is essential for correct diagnosis and treatment.

Rights and Permissions

Citation: Am J Orthop (Belle Mead NJ). 2015 Dec;44(12):563-8.

Related Resources

Link to Article in PubMed

PubMed ID

26665244