eosinophilic granuloma

Introduction

Unifocal Langerhans' cell histiocytosis; single site of involvement.

Pathology

• single osteolytic bony lesion is most common
• skin & soft tissue lesions

Clinical manifestations

• pain &/or swelling over underlying bony lesion
• cutaneous or subcutaneous nodule, generally yellow; may be tender & breakdown; generalized distribution
• disruption of teeth with mandibular disease
• fracture
• otitis media due to mastoid involvement
• sharply marginated, recalcitrant ulcer on oral mucosa or genital region (necrotic, draining, tender)
• lesions often asymptomatic

Radiology

• plain radiographs:
  • osteolytic lesion
    • adults: most commonly rib
    • children: most commonly calvarium, femur

Management

• prognosis: benign course with good prognosis for spontaneous recovery
• curettage with or without bony chip packing
• low-dose (300-600 rad) radiotherapy
• surgical excision of extraosseous soft tissue lesions

More general terms

• Langerhans cell histiocytosis (LCH); histiocytosis X

Patient information

eosinophilic granuloma patient information