EURORAD ESR

Case 962

Langerhans Cell Histiocytosis

Author(s)
T. Weits, G.J.I.M. van der Werf
 
Patient
male, 27 year(s)
 
 
  • Figure 1
    Conventional radiography of the lumbar spine

    Conventional radiography of the lumbar spine, a-p projection shows deformation of L1 and L2 vertebral bodies with narrowing of the intervertebral disc space. Vertebral pedicles are hardly visible on a-p projection.

     
    Area of Interest: unknown; Imaging Technique: Conventional radiography of the lumbar spine;
     
     
  • Figure 2
    Radiography of the chest

    Radiography of the chest, AP view demonstrates fine reticular pattern of the pulmonary interstitium on both lungs without alveolar consolidation, lymphadenopathy or pleural effusion.

     
    Area of Interest: unknown; Imaging Technique: Radiography of the chest;
     
     
  • Figure 3
    MRI of the lumbar spine
     

    TSE T1-weighted image shows malformation and abnormal signal intensities of T12, L1 and L2 vertebral bodies and pathological tissue showing isointensity on T1- and hyperintensity on T2-weighted sequences, with slight...

     
    Area of Interest: unknown; Imaging Technique: MRI of the lumbar spine;

    GE T2-weighted image. Same caption as 3a.

     
    Area of Interest: unknown; Imaging Technique: MRI of the lumbar spine;
     
     
  • Figure 4
    MRI of the cervico-thoracic spine
     

    Sagittal TSE T1-weighted image bone marrow infiltration of three adjacent vertebrae (Th4, Th5, Th6). Malformation and signal intensities are comparable with that of the lesions described at the lumbar spine. No...

     
    Area of Interest: unknown; Imaging Technique: MRI of the cervico-thoracic spine;

    GE T2-weighted image.

     
    Area of Interest: unknown; Imaging Technique: MRI of the cervico-thoracic spine;
     
     
Conventional radiography of the lumbar spine, a-p projection shows deformation of L1 and L2 vertebral bodies with narrowing of the intervertebral disc space. Vertebral pedicles are hardly visible on a-p projection.
 
Radiography of the chest, AP view demonstrates fine reticular pattern of the pulmonary interstitium on both lungs without alveolar consolidation, lymphadenopathy or pleural effusion.
 
TSE T1-weighted image shows malformation and abnormal signal intensities of T12, L1 and L2 vertebral bodies and pathological tissue showing isointensity on T1- and hyperintensity on T2-weighted sequences, with slight enhancement after Gadolinium administration (not shown). Mild kyphosis and deviation of the spinal cord and scalloping of the posterior wall of the involved vertebral bodies are noted.
 
GE T2-weighted image. Same caption as 3a.
 
Sagittal TSE T1-weighted image bone marrow infiltration of three adjacent vertebrae (Th4, Th5, Th6). Malformation and signal intensities are comparable with that of the lesions described at the lumbar spine. No evidence of intrathecal pathology is visible. Clinical data and imaging findings suggest a systemic disease. A CT-guided biopsy of L1 was performed. Histological examination revealed Langerhans histiocytosis.
 
GE T2-weighted image.
 
 
 
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