Langerhans Cell Histiocytosis

Etiology: abnormal proliferation of Langerhans cells
Imaging: punched out osteolytic lesions with beveled edges, can involve diaphysis, floating teeth, vertebra plana in spine with soft tissue paravertebral mass
Clinical: Bone scan or skeletal survey to assess for / monitor distant lesions

Cases of Langerhans Cell Histiocytosis

Radiograph and MRI of Langerhans cell histiocytosis of the spine — Lateral radiograph of the lumbar spine shows loss of height of the L1 vertebral body. Coronal and sagittal T1 MRI with contrast of the lumbar spine shows flattening (vertebra plana) and enhancement of the L1 vertebral body with a small enhancing right sided paravertebral mass.

Radiograph of Langerhans Cell Histiocytosis of the femur — AP radiograph of the pelvis shows a well circumscribed lytic lesion in the proximal right femoral metaphysis without any associated periosteal reaction.