Extracranial skeletal Langerhans cell histiocytosis

MR imaging features according to the radiologic evolutional phases

Su Kyung Jeh, Won Hee Jee, Suk-Joo Hong, Jee Young Kim, Mi Sook Sung, Kyung Nam Ryu, Soo A. Im, Kyung Ah Chun, Yeon Soo Lee, Jae Hyun Cho

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: The purpose was to describe the magnetic resonance (MR) findings of extracranial skeletal Langerhans cell histiocytosis according to the radiologic evolutional phases. Materials and methods: Twenty-two patients with pathologically confirmed extracranial skeletal Langerhans cell histiocytosis were included. The lesions were classified as early, mid, and late phases according to the radiologic evolutional phases. MR images were retrospectively analyzed regarding signal intensity, internal hypointense band, fluid levels, periosteal reaction, adjacent bone marrow and soft tissue abnormal signal, and patterns of contrast enhancement in each phase. Results: According to the radiologic evolutional phases, there were 4 patients with early phase, 16 with mid phase, and 2 with late phase. All cases showed hypointense to intermediate signal intensity on T1-weighted images. On T2-weighted images, 12 (55%) of the 22 lesions were hyperintense, and 10 (45%) showed intermediate signal. All lesions showed diffusely heterogeneous signal on T2-weighted images. Internal low-signal bands of the lesions were observed in 13 cases (59%). There were two cases with fluid levels in mid phase. Periosteal reaction was observed in 13 (59%) cases. Adjacent bone marrow or soft tissue abnormal signal was observed in 20 cases (91%), respectively. According to early, mid, and late phases, bone marrow and soft tissue abnormal signals were observed in 100%, 100%, and 0% cases, respectively. Soft tissue mass was seen in eight cases (36%). Ten (46%) lesions showed cortical destruction, including one patient with a pathologic fracture. Among 21 patients with contrast infusion, diffuse enhancement was observed in 19 patients (90%), and marginal and septal enhancement was seen in 2 patients (10%). Conclusion: MR imaging was helpful in the diagnosis of extracranial skeletal Langerhans cell histiocytosis, particularly in early and mid phases.

Original languageEnglish
Pages (from-to)466-471
Number of pages6
JournalClinical Imaging
Volume36
Issue number5
DOIs
Publication statusPublished - 2012 Sep 1

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Langerhans Cell Histiocytosis
Magnetic Resonance Imaging
Bone Marrow
Magnetic Resonance Spectroscopy
Spontaneous Fractures

Keywords

  • Bone
  • Eosinophilic granuloma
  • Extracranial Langerhans cell histiocytosis
  • MR imaging
  • Neoplasms
  • Tumors

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Extracranial skeletal Langerhans cell histiocytosis : MR imaging features according to the radiologic evolutional phases. / Jeh, Su Kyung; Jee, Won Hee; Hong, Suk-Joo; Kim, Jee Young; Sung, Mi Sook; Ryu, Kyung Nam; Im, Soo A.; Chun, Kyung Ah; Lee, Yeon Soo; Cho, Jae Hyun.

In: Clinical Imaging, Vol. 36, No. 5, 01.09.2012, p. 466-471.

Research output: Contribution to journalArticle

Jeh, Su Kyung ; Jee, Won Hee ; Hong, Suk-Joo ; Kim, Jee Young ; Sung, Mi Sook ; Ryu, Kyung Nam ; Im, Soo A. ; Chun, Kyung Ah ; Lee, Yeon Soo ; Cho, Jae Hyun. / Extracranial skeletal Langerhans cell histiocytosis : MR imaging features according to the radiologic evolutional phases. In: Clinical Imaging. 2012 ; Vol. 36, No. 5. pp. 466-471.
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abstract = "Purpose: The purpose was to describe the magnetic resonance (MR) findings of extracranial skeletal Langerhans cell histiocytosis according to the radiologic evolutional phases. Materials and methods: Twenty-two patients with pathologically confirmed extracranial skeletal Langerhans cell histiocytosis were included. The lesions were classified as early, mid, and late phases according to the radiologic evolutional phases. MR images were retrospectively analyzed regarding signal intensity, internal hypointense band, fluid levels, periosteal reaction, adjacent bone marrow and soft tissue abnormal signal, and patterns of contrast enhancement in each phase. Results: According to the radiologic evolutional phases, there were 4 patients with early phase, 16 with mid phase, and 2 with late phase. All cases showed hypointense to intermediate signal intensity on T1-weighted images. On T2-weighted images, 12 (55{\%}) of the 22 lesions were hyperintense, and 10 (45{\%}) showed intermediate signal. All lesions showed diffusely heterogeneous signal on T2-weighted images. Internal low-signal bands of the lesions were observed in 13 cases (59{\%}). There were two cases with fluid levels in mid phase. Periosteal reaction was observed in 13 (59{\%}) cases. Adjacent bone marrow or soft tissue abnormal signal was observed in 20 cases (91{\%}), respectively. According to early, mid, and late phases, bone marrow and soft tissue abnormal signals were observed in 100{\%}, 100{\%}, and 0{\%} cases, respectively. Soft tissue mass was seen in eight cases (36{\%}). Ten (46{\%}) lesions showed cortical destruction, including one patient with a pathologic fracture. Among 21 patients with contrast infusion, diffuse enhancement was observed in 19 patients (90{\%}), and marginal and septal enhancement was seen in 2 patients (10{\%}). Conclusion: MR imaging was helpful in the diagnosis of extracranial skeletal Langerhans cell histiocytosis, particularly in early and mid phases.",
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AU - Kim, Jee Young

AU - Sung, Mi Sook

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