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Skeletal involvement in Langerhans cell histiocytosis
Suonita Khung1, Jean-François Budzik, Elisa Amzallag-Bellenger
1Department of Pediatric Radiology, Hôpital Jeanne de Flandre, Université de Lille 2, CHRU de Lille, Lille, France.
Insights Into Imaging
|August 3, 2013
Summary
Langerhans cell histiocytosis (LCH) is a rare condition causing abnormal histiocyte buildup in bones. This essay details typical and unusual bone LCH presentations, aiding diagnosis in children.
Area of Science:
- Radiology
- Pediatric Oncology
- Histiocytosis
Background:
- Langerhans cell histiocytosis (LCH) involves abnormal histiocyte accumulation in various tissues.
- Skeletal involvement is common in pediatric LCH, affecting flat bones, spine, and long bones.
- LCH bone lesions can mimic malignant tumors or osteomyelitis, complicating diagnosis.
Purpose of the Study:
- To present the characteristic and atypical skeletal manifestations of LCH in children.
- To aid radiologists and clinicians in identifying LCH bone lesions.
- To differentiate LCH from other bone pathologies.
Main Methods:
- Pictorial essay format.
- Review of imaging findings in pediatric LCH skeletal cases.
- Correlation of radiographic features with clinical presentation.
Main Results:
- Solitary lytic skull lesions and "vertebra plana" are typical radiographic findings.
- Extensive bone marrow MRI signal changes are indicative of LCH.
- Endosteal scalloping in long bones can present as a "budding appearance".
Conclusions:
- Osseous LCH in children shares similarities with multiple myeloma.
- Radiographic and MRI findings are crucial for diagnosing LCH.
- Recognizing specific patterns like "vertebra plana" and "budding appearance" improves diagnostic accuracy.