Langerhans Cell Histiocytosis

  • Etiology: abnormal proliferation of Langerhans cells
  • Radiograph: distribution in flat bones and long bones, well circumscribed lytic lesions with beveled edges with +/- periosteal reaction and with +/- sclerotic rim, can involve floating teeth, vertebra plana in spine with soft tissue paravertebral mass
  • MR: lesions filled with soft tissue without large mass, often homogeneously bright / enhancing, +/- marrow edema >> soft tissue edema
  • Clinical: Bone scan or skeletal survey to assess for / monitor distant lesions

Radiology 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.