Langerhans cell histiocytosis involving right humerus

Case contributed by Jack Ren

Presentation

4 year old male present with sore arm

Patient Data

Age: 4
Gender: Male

There is a ill defined lytic lesion located on the right humeral shaft involving the middle 1/3. It has a permiative appearance and is associated with periosteal reaction best seen anteriorly. 

Bone scan

Nuclear medicine

There is a increase uptake on patient's right humeral shaft.

There is heterogenous lesion locate on right humerus involving diaphysis and humeral head. There is increased T2 signal in the adjacent soft tissues and periosteal reaction is visible both anteriorly and posteriorly as a T2 dark line. 

This child went on to have a biopsy which confirmed the diagnosis of Langerhans cell histiocytosis. 

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