Bone Tumors
A 7-year-old boy presents with 3 months of localized skull pain. X-ray shows a well-defined, "punched-out" lytic lesion in the parietal bone without sclerotic margins. There is no soft tissue mass. He has no systemic symptoms, no other bone lesions on skeletal survey, and normal laboratory studies. Biopsy shows histiocytes with reniform (kidney-shaped) nuclei, abundant eosinophils, and electron microscopy reveals Birbeck granules. Regarding Langerhans cell histiocytosis:
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Langerhans cell histiocytosis (LCH) is a clonal proliferation of Langerhans cells (dendritic antigen...
The diagnosis is confirmed by the presence of Birbeck granules on electron microscopy (pathognomonic...
LCH is a malignant condition; disseminated disease has the best prognosis; Birbeck granules are foun...
Common bone locations include skull (most common), femur, pelvis, ribs, and vertebrae (can cause ver...
Solitary eosinophilic granuloma often resolves spontaneously or can be treated with curettage Ā± bone...
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