eMedicine Specialties > Radiology > Musculoskeletal

Eosinophilic Granuloma, Skeletal: Multimedia

Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, Consultant Radiologist, North Manchester General Hospital, The Pennine Acute NHS Trust, Manchester UK
Coauthor(s): Muthusamy Chandramohan, MBBS, DMRD, FRCR, Consultant Radiologist, Bradford Teaching Hospitals, UK; Ian Turnbull, MB, ChB, MD, DMRD, FRCR, Lecturer, Department of Radiology, University of Manchester; Consulting Neuroradiologist, Hope Hospital, Salford, Manchester and North Manchester General Hospital, UK; Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute
Contributor Information and Disclosures

Updated: May 14, 2008

Multimedia

Chest radiograph in a 30-year-old woman who prese...
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Media file 1: Chest radiograph in a 30-year-old woman who presented with shortness of breath and a palpable swelling over the right parietal region. The radiograph shows an interstitial lung pattern with a honeycomb appearance in the upper zones (see also Image 2 in Multimedia).
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Chest radiograph in a 30-year-old woman who prese...

Chest radiograph in a 30-year-old woman who presented with shortness of breath and a palpable swelling over the right parietal region. The radiograph shows an interstitial lung pattern with a honeycomb appearance in the upper zones (see also Image 2 in Multimedia).

Lateral skull radiograph in a 30-year-old woman w...
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Media file 2: Lateral skull radiograph in a 30-year-old woman with shortness of breath and a palpable swelling over the right parietal region (same patient as in Image 1 in Multimedia) shows 2 purely lytic lesions in the frontoparietal region of the skull. The larger parietal lesion has beveled edges, suggestive of an eosinophilic granuloma. Biopsy results confirmed the diagnosis of eosinophilic granuloma.
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Lateral skull radiograph in a 30-year-old woman w...

Lateral skull radiograph in a 30-year-old woman with shortness of breath and a palpable swelling over the right parietal region (same patient as in Image 1 in Multimedia) shows 2 purely lytic lesions in the frontoparietal region of the skull. The larger parietal lesion has beveled edges, suggestive of an eosinophilic granuloma. Biopsy results confirmed the diagnosis of eosinophilic granuloma.

Transaxial nonenhanced CT scans of the skull in a...
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Media file 3: Transaxial nonenhanced CT scans of the skull in a 28-year-old woman who presented with a palpable swelling over the calvarium. Scanogram of the patient's skull shows a geographic lytic lesion within the parieto-occipital region. Transaxial scan through the vertex, examined in a bone window, shows an expanding lytic lesion within the diploic space (see also Images 4-5 in Multimedia).
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Transaxial nonenhanced CT scans of the skull in a...

Transaxial nonenhanced CT scans of the skull in a 28-year-old woman who presented with a palpable swelling over the calvarium. Scanogram of the patient's skull shows a geographic lytic lesion within the parieto-occipital region. Transaxial scan through the vertex, examined in a bone window, shows an expanding lytic lesion within the diploic space (see also Images 4-5 in Multimedia).

Transaxial nonenhanced CT scans through the verte...
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Media file 4: Transaxial nonenhanced CT scans through the vertex in a 28-year-old woman with a palpable swelling over the calvarium (same patient as in Image 3 in Multimedia), examined in a brain window. Images show destruction of both the outer and inner tables of skull; however, no brain involvement is noted.
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Transaxial nonenhanced CT scans through the verte...

Transaxial nonenhanced CT scans through the vertex in a 28-year-old woman with a palpable swelling over the calvarium (same patient as in Image 3 in Multimedia), examined in a brain window. Images show destruction of both the outer and inner tables of skull; however, no brain involvement is noted.

Radionuclide bone scans in a 28-year-old woman wi...
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Media file 5: Radionuclide bone scans in a 28-year-old woman with a palpable swelling over the calvarium (same patient as in Images 3-4 in Multimedia) show a solitary lesion within the skull and a photon-deficient mass surrounded by a rim of intense activity. Biopsy results confirmed the diagnosis of eosinophilic granuloma.
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Radionuclide bone scans in a 28-year-old woman wi...

Radionuclide bone scans in a 28-year-old woman with a palpable swelling over the calvarium (same patient as in Images 3-4 in Multimedia) show a solitary lesion within the skull and a photon-deficient mass surrounded by a rim of intense activity. Biopsy results confirmed the diagnosis of eosinophilic granuloma.

Anteroposterior radiograph of the mandible (left ...
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Media file 6: Anteroposterior radiograph of the mandible (left image) in a 10-year-old boy who presented with swelling of the left mandible. A lytic expanding lesion is seen within the ramus of the left mandible. An oblique view of the mandible (right image) shows floating teeth within the lytic bone lesion) (see also Image 7 in Multimedia).
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Anteroposterior radiograph of the mandible (left ...

Anteroposterior radiograph of the mandible (left image) in a 10-year-old boy who presented with swelling of the left mandible. A lytic expanding lesion is seen within the ramus of the left mandible. An oblique view of the mandible (right image) shows floating teeth within the lytic bone lesion) (see also Image 7 in Multimedia).

External carotid angiogram in a 10-year-old boy w...
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Media file 7: External carotid angiogram in a 10-year-old boy with swelling of the left mandible (same patient as in Image 6 in Multimedia) shows an avascular mass within the mandible with stretching of the vessels around the lytic lesion. Biopsy results confirmed the diagnosis of eosinophilic granuloma.
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External carotid angiogram in a 10-year-old boy w...

External carotid angiogram in a 10-year-old boy with swelling of the left mandible (same patient as in Image 6 in Multimedia) shows an avascular mass within the mandible with stretching of the vessels around the lytic lesion. Biopsy results confirmed the diagnosis of eosinophilic granuloma.

Plain radiograph of the pelvis in a 10-year-old g...
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Media file 8: Plain radiograph of the pelvis in a 10-year-old girl shows a lytic lesion of eosinophilic granuloma within the left ileum. Biopsy results confirmed the diagnosis of eosinophilic granuloma.
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Plain radiograph of the pelvis in a 10-year-old g...

Plain radiograph of the pelvis in a 10-year-old girl shows a lytic lesion of eosinophilic granuloma within the left ileum. Biopsy results confirmed the diagnosis of eosinophilic granuloma.

Chest radiograph in a 9-year-old boy who presente...
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Media file 9: Chest radiograph in a 9-year-old boy who presented with mid dorsal pain. Note the collapsed vertebra and paraspinal soft tissue mass.
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Chest radiograph in a 9-year-old boy who presente...

Chest radiograph in a 9-year-old boy who presented with mid dorsal pain. Note the collapsed vertebra and paraspinal soft tissue mass.

Anteroposterior radiograph of the dorsal spine in...
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Media file 10: Anteroposterior radiograph of the dorsal spine in a 9-year-old boy with mid dorsal pain (same patient as in Image 9 in Multimedia). These results confirm the chest radiographic findings.
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Anteroposterior radiograph of the dorsal spine in...

Anteroposterior radiograph of the dorsal spine in a 9-year-old boy with mid dorsal pain (same patient as in Image 9 in Multimedia). These results confirm the chest radiographic findings.

T1-weighted nonenhanced sagittal MRI through the ...
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Media file 11: T1-weighted nonenhanced sagittal MRI through the spine in a 9-year-old boy with mid dorsal pain (same patient as in Images 9-10 in Multimedia) shows the vertebra plana. Note the preserved disk spaces. Biopsy results confirmed the diagnosis of eosinophilic granuloma.
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T1-weighted nonenhanced sagittal MRI through the ...

T1-weighted nonenhanced sagittal MRI through the spine in a 9-year-old boy with mid dorsal pain (same patient as in Images 9-10 in Multimedia) shows the vertebra plana. Note the preserved disk spaces. Biopsy results confirmed the diagnosis of eosinophilic granuloma.

More on Eosinophilic Granuloma, Skeletal

Overview: Eosinophilic Granuloma, Skeletal
Imaging: Eosinophilic Granuloma, Skeletal
Follow-up: Eosinophilic Granuloma, Skeletal
Multimedia: Eosinophilic Granuloma, Skeletal
References
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References

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  2. Haouimi AS, Al-Hawsawi ZM, Jameel AN. Unusual location of eosinophilic granuloma. Saudi Med J. Oct 2004;25(10):1489-91. [Medline].

  3. Park SH, Park J, Hwang JH, Hwang SK, Hamm IS, Park YM. Eosinophilic granuloma of the skull: a retrospective analysis. Pediatr Neurosurg. 2007;43(2):97-101. [Medline].

  4. Vanhoenacker FM, De Beuckeleer LH, De Roeck F, et al. Metachronous eosinophilic granuloma of bone. JBR-BTR. Oct 2000;83(5):234-7. [Medline].

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  7. Yanagawa T, Watanabe H, Shinozaki T, et al. The natural history of disappearing bone tumours and tumour-like conditions. Clin Radiol. Nov 2001;56(11):877-86. [Medline].

  8. Raab P, Hohmann F, Kuhl J, Krauspe R. Vertebral remodeling in eosinophilic granuloma of the spine. A long- term follow-up. Spine. Jun 15 1998;23(12):1351-4. [Medline].

  9. Silvestros SS, Mamalis AA, Sklavounou AD, Tzerbos FX, Rontogianni DD. Eosinophilic granuloma masquerading as aggressive periodontitis. J Periodontol. May 2006;77(5):917-21. [Medline].

  10. Greenlee JD, Fenoy AJ, Donovan KA, Menezes AH. Eosinophilic granuloma in the pediatric spine. Pediatr Neurosurg. 2007;43(4):285-92. [Medline].

  11. Fenoy AJ, Greenlee JD, Menezes AH, Donovan KA, Sato Y, Hitchon PW, et al. Primary bone tumors of the spine in children. J Neurosurg. Oct 2006;105(4 Suppl):252-60. [Medline].

  12. Flores LG 2nd, Hoshi H, Nagamachi S, et al. Thallium-201 uptake in eosinophilic granuloma of the frontal bone: comparison with technetium-99m-MDP imaging. J Nucl Med. Jan 1995;36(1):107-10. [Medline].

  13. Carrasco CH, Wallace S, Richli WR. Percutaneous skeletal biopsy. Cardiovasc Intervent Radiol. Jan-Feb 1991;14(1):69-72. [Medline].

  14. Osenbach RK, Youngblood LA, Menezes AH. Atlanto-axial instability secondary to solitary eosinophilic granuloma of C2 in a 12-year-old girl. J Spinal Disord. Dec 1990;3(4):408-12. [Medline].

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Further Reading

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Keywords

EG, Langerhans cell histiocytosis, histiocytosis X, Letterer-Siwe disease, Hand-Schüller-Christian disease, skeletal eosinophilic granuloma, unifocal Langerhans cell histiocytosis, solitary skeletal lesions, bone lesions, multiple skeletal lesions, skeletal lesions, solitary bone lesions, multiple bone lesions

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Contributor Information and Disclosures

Author

Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, Consultant Radiologist, North Manchester General Hospital, The Pennine Acute NHS Trust, Manchester UK
Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR is a member of the following medical societies: American Institute of Ultrasound in Medicine, Royal College of Physicians, Royal College of Physicians and Surgeons of the United States, Royal College of Radiologists, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

Coauthor(s)

Muthusamy Chandramohan, MBBS, DMRD, FRCR, Consultant Radiologist, Bradford Teaching Hospitals, UK
Disclosure: Nothing to disclose.

Ian Turnbull, MB, ChB, MD, DMRD, FRCR, Lecturer, Department of Radiology, University of Manchester; Consulting Neuroradiologist, Hope Hospital, Salford, Manchester and North Manchester General Hospital, UK
Disclosure: Nothing to disclose.

Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute
Sumaira MacDonald, MBChB, PhD, MRCP, FRCR is a member of the following medical societies: British Medical Association, Royal College of Physicians, and Royal College of Radiologists
Disclosure: Nothing to disclose.

Medical Editor

Michael A Bruno, MD, Associate Professor, Departments of Radiology and Medicine, Pennsylvania State University College of Medicine; Director, Radiology Quality Management Services, Milton S Hershey Medical Center, Pennsylvania State University College of Medicine
Michael A Bruno, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Association of University Radiologists, Radiological Society of North America, Society of Nuclear Medicine, and Society of Skeletal Radiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Murali Sundaram, MBBS, FRCR, FACR, Consulting Staff, Department of Diagnostic Radiology, The Cleveland Clinic Foundation
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, Resolution Imaging Medical Corporation
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Felix S Chew, MD, MBA, EdM, Professor, Department of Radiology, Vice Chairman for Radiology Informatics, Section Head of Musculoskeletal Radiology, University of Washington
Felix S Chew, MD, MBA, EdM is a member of the following medical societies: American Roentgen Ray Society, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

 
 
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