Imaging of Osseous Lesions in Langerhans Cell Histiocytosis (LCH)
Journal Title: Indian Journal of Applied Radiology - Year 2017, Vol 3, Issue 1
Abstract
Introduction: Langerhans Cell Histiocytosis (LCH) is a rare condition resulting from idiopathic proliferation of histiocytes and can affect any organ but is more often seen in bone, lung, skin, lymph nodes and endocrine glands. This paper is aimed at analyzing the imaging patterns of osseous involvement in cases of LCH. Material and methods: It is a retrospective analysis of 18 histopathologically proven cases of LCH with osseous involvement done at our institute over the last 5 years. Results: Of the total patients, 13 were males. Most were aged less than 10 years old. The bones involved were skull (n=9), long bones (n=6), vertebrae (n=5), pelvis (n=3), rib (n=1) and clavicle (n=1). Enhancement of soft tissue component was seen in 10 cases. Radiological features depend on site of involvement and phase of disease. Early phase lesions are lytic poorly defined. Lamellated periosteal reaction along with pathological fracture was noted in some. Later, the lesions became more clearly defined with sharp border. Chronic lesions were sclerotic. In our study, involvement of clavicle and posterior element of vertebrae and more affection of cervical than thoracic spine are unusual findings. Conclusions: Though LCH is common in children less than 2 years, it can occur at any age. Skull involvement is the most common site for bony lesions. Unusual sites like clavicle may be involved. We observed that cervical spine is frequently affected and posterior element involvement is also not uncommon. Full skeletal survey with appropriate imaging is recommended after an initial diagnosis.
Authors and Affiliations
Dr. Sujata Patnaik
Keywords
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