Benign histiocytoma (xanthoma) of the rib

A 64-year-old man was found to have isolated focal rib lesion(s) by radiographs and radionuclide bone scan. A biopsy of one of the lesions located by imaging was done. The histologic diagnosis was sclerosing (ossifying) xanthoma. A literature search disclosed that xanthomatous lesions of bone are only one of the manifestations in hyperlipidemic patients. These benign lesions should be included among the causes of discrete hot rib abnormalities visualized on bone scan.