Langerhans cell histeocytosis (LCH)

Case contributed by Andrew Kirby
Diagnosis almost certain

Presentation

Lump on head noticed by mother. Has been gradually enlarging over 2 months.

Patient Data

Age: 5 years
Gender: Female
ultrasound

Well defined low reflectivity mass with no internal vascularity. Destruction of the outer and inner tables of the skull with a beveled edge appearance. The degree of posterior acoustic enhancement is not typical of a cystic lesion such as a dermoid.

Bone destruction of both inner and outer tables with beveled edge apperance. Overlying soft tissue lump is better seen on ultrasound.

Case Discussion

Typical appearances of a solitary, single system langerhans cell histeocytosis (LCH) lesion. This lesion has historically been referred to as an eosinophilic granuloma.

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