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Soft tissue signal abnormality associated with eosinophilic granuloma. Correlation of MR imaging with pathologic
M Monroc1, H Ducou le Pointe, S Haddad
1Department of Pediatric Radiology, Hôpital d'Enfants Armand-Trousseau, Paris, France.
Abstract:
Six patients with eosinophilic granuloma were studied retrospectively in order to correlate the MRI appearances with the pathology. Ages ranged from 2 years 6 months to 11 years. The bones involved were the humerus, ulna, radius, femur, clavicle and ilium. Plain films, MRI and pathology specimens were obtained. A lytic lesion with indistinct margins, endosteal erosions and periosteal reaction was seen in all cases on plain radiographs. Bone marrow signal was decreased on T1-weighted images and increased on T2-weighted images throughout the bony lesion in all cases. T2-weighted images showed extensive soft-tissue abnormalities suggesting inflammatory changes in four cases. In two cases abnormalities were limited. Extensive changes correlated histologically with an early phase lesion. Localized minor changes were associated with a mid-phase lesion. Inflammatory soft-tissue changes could be associated with eosinophilic granuloma. The size of the soft tissue mass correlated well with the activity of the bony lesion.
Insights
Magnetic resonance imaging (MRI) can reveal soft-tissue abnormalities in eosinophilic granuloma (EG). These findings correlate with the disease phase and bony lesion activity, aiding diagnosis.
Area of Science:
- Radiology
- Orthopedic Pathology
- Pediatric Imaging
Background:
- Eosinophilic granuloma (EG) is a rare benign histiocytosis affecting bone.
- Accurate diagnosis relies on correlating imaging findings with pathological features.
Purpose of the Study:
- To correlate magnetic resonance imaging (MRI) findings with histopathological characteristics of eosinophilic granuloma (EG).
- To evaluate the utility of MRI in assessing disease activity and phase in EG.
Main Methods:
- Retrospective analysis of six pediatric patients diagnosed with EG.
- Correlation of plain radiographs, MRI (T1 and T2-weighted images), and surgical pathology specimens.
Main Results:
- Radiographs showed lytic lesions with indistinct margins, endosteal erosions, and periosteal reactions in all cases.
- MRI revealed decreased bone marrow signal on T1 and increased signal on T2-weighted images.
- T2-weighted images demonstrated soft-tissue abnormalities, extensive in early-phase lesions and limited in mid-phase lesions, correlating with histological findings and bony lesion activity.
Conclusions:
- Soft-tissue abnormalities on MRI are associated with eosinophilic granuloma.
- MRI findings, particularly T2-weighted signal changes and soft-tissue extent, correlate with the histological phase and activity of EG bony lesions.