EURORAD ESR

Case 13382

Multisystemic Langerhans cell hystiocitosis - Head and neck involvement

Author(s)
Prat-Matifoll J.A, Delgado I, Barber I, Ángel Sánchez-Montañez García-Carpintero, Elida Vázquez

Vall Hebron Hospital,
Institut Català de la Salut,
Radiology;
Passeig Vall Hebrón 116-119
08035 Barcelona, Spain;
Email:joanalbertpratrx@gmail.com
 
Patient
male, 11 month(s)
 
 
  • Figure 1
    Skull X-ray

    Well-defined lytic lesion with a double contour (hole within a hole = button sequestrum) and geographic margins, associated to a growing soft-tissue mass (yellow arrows).

     
    Area of Interest: Bones; Imaging Technique: Plain radiographic studies; Procedure: Education; Special Focus: Neoplasia;
     
     
  • Figure 2
    Sonography

    Soft-tissue lesion destroying the skull (blue arrows), leaving multiple hyperechoic calcifications inside, which show a twinkling artifact (red arrows). Mild Doppler signal within the lesion was observed.

     
    Area of Interest: Bones; Imaging Technique: Ultrasound; Procedure: eLearning; Special Focus: Neoplasia;
     
     
  • Figure 3
    MRI and PET-CT

    Osteolytic soft-tissue mass showing an heterogeneous and periferical enhancement as well as a restricted diffusion. PET-CT showed an increased F-18 FDG uptake (SUVmax: 5.0) (blue arrow)

     
    Area of Interest: Bones; Imaging Technique: MR; Procedure: Localisation; Special Focus: Hyperplasia / Hypertrophy;
     
     
Well-defined lytic lesion with a double contour (hole within a hole = button sequestrum) and geographic margins, associated to a growing soft-tissue mass (yellow arrows).
 
Soft-tissue lesion destroying the skull (blue arrows), leaving multiple hyperechoic calcifications inside, which show a twinkling artifact (red arrows). Mild Doppler signal within the lesion was observed.
 
Osteolytic soft-tissue mass showing an heterogeneous and periferical enhancement as well as a restricted diffusion. PET-CT showed an increased F-18 FDG uptake (SUVmax: 5.0) (blue arrow)
 
 
 
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