Percutaneous Techniques for the Diagnosis and Treatment of Localized Langerhans-Cell Histiocytosis (Eosinophilic Granuloma of Bone)* by ALAN W. YASKO,

Percutaneous Techniques for the Diagnosis and Treatment of Localized Langerhans-Cell Histiocytosis (Eosinophilic

Granuloma of Bone)*

by ALAN W. YASKO, CHRISTINA V. FANNING, ALBERTO G. AYALA, C. HUMBERTO CARRASCO, and JOHN A. MURRAY

J Bone Joint Surg AmVolume 80(2):219-28

February 1, 1998

©1998 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1 Skeletal distribution of the osseous lesions of Langerhans-cell histiocytosis in the present series.

ALAN W. YASKO et al. J Bone Joint Surg Am 1998;80:219-28


Fig. 2-A Cytological smear of material obtained with fine-needle aspiration, demonstrating histiocytes with abundant cytoplasm and grooved or infolded eccentric nuclei, characteristic of

Langerhans histiocytes.



Fig. 2-B Histological section of a specimen obtained with core-needle biopsy, demonstrating large pale-staining histiocytes (arrows) with eccentric nuclei and nuclear grooves.



Fig. 3-A: Radiograph indicating a diagnosis of Langerhans-cell histiocytosis (arrow) of the proximal part of the femur in a ten-year-old girl who had a three-month history of pain in the left

thigh and an associated limp.



Fig. 3-B: Radiograph showing complete healing of the femoral lesion by four months.



Fig. 4-A Plain radiograph demonstrating a destructive lesion of the superior pubic ramus (arrows) in a ten-year-old boy who was seen because of inguinal pain and a limp of one month's

duration with no history of injury.



Fig. 4-B Computerized tomography scan delineating the extent of cortical thinning and expansion (arrow).



Fig. 4-C: Radiograph showing healing four weeks after injection of 125 milligrams of methylprednisolone.



Fig. 4-D: Radiograph showing remodeling of the pubis eight months after treatment.



Fig. 5-A: Radiograph showing a permeative lesion of the distal part of the humerous associated with a solid, uninterrupted periosteal reaction (arrows), suggestive of osteomyelitis or

Langerhans-cell histiocytosis, in a nine-year-old boy who had a one-month...



Figs. 5-B, 5-C, and 5-D: Radiographs made six weeks, sixteen weeks, and two years after treatment, demonstrating progressive healing and bone-remodeling.









Documents

Percutaneous Techniques for the Diagnosis and Treatment of Localized Langerhans-Cell Histiocytosis (Eosinophilic Granuloma of Bone)* by ALAN W. YASKO,