eosinophilic granuloma

• 60-80% of histiocytosis X
• age 5 - 10 yrs
• presentation: bone pain, local swelling, irritability

• bones
  • 50 - 75% solitary / monostotic
  • skull/mandible (50%): "punched-out" lucencies, "hole within a hole", "button sequestrum", "floating teeth"
  • spine/pelvis (25%): vertebra plana (most common pediatric cause)
  • long bones (15%): medullary lucency +/- thin sclerotic rim

• lungs
  • involved in <10%, signals worse prognosis
  • apical reticulonodular infiltrates
  • honeycomb lung

© 2002, C.E. Kahn, Jr.
2002-04-18