Langerhan’s Histiocytosis (Eosinophilic Granuloma)

FACTS

  • proliferation of Langerhan cells
  • pathophysiology: abundance of eosinophils, lymphocytes, neutrophils that produce….
    • prostaglandins → medullary bone resorption
  • Locations:
    • skull (50%), pelvis (23%), femur (17%), ribs (8%), humerus (7%), mandible (7%), spine (7%)
 

HPI

 

PHYSICAL EXAM

IMAGING

  • evaluate spine for vertebral plana (collapsed spine)
  • skull lesions = punched out w/ sclerotic rim
notion image
 
A/P
Treatment:
  • observation
  • radiation
  • bracing
  • indomethacin
  • steroid injections
  • ablation
  • excision
  • chemotherapy

I-MELT (vertebral plana mnemonic)

infection, metastasis/myeloma, eosinophilic granuloma, lymphoma/leukemia, trauma/tuberculosis