MRI and Histopathologic Classification of Langerhans Cell Histiocytosis

Abstract

Objective: The purpose of the study was to determine the stage of magnetic resonance images (MRI) of Langerhans cell histiocytosis (LCH). Materials and Methods:The MR images of 16 patients with a histopathologically proven diagnosis of LCH by curettage biopsy were analyzed retrospectively. There were 9 female and 7 male patients, age range 1-36 years, mean age 8.7 years. Lesions were located in the humerus (n=5), the femur (n=4), the pelvic ilium (n=3), the tibia (n=2), the scapula (n=1), and the metacarpal (n=1). We classified 'type A' as full hypercellularity lesion, 'type B' as peripheral hypercellularity and central fibrosis, and 'type C' as reduced cellularity on MRI of LCH. Histopathologic evolution of LCH comprised four different phases.Results: Four of 16 patients, who were reconfirmed to the first incipient phase of LCH histopathologically, revealed as one 'type A', two 'type A and B', and one 'type B'. Eight patients with the second phase revealed seven 'type B' and one 'type B and C' on the MRI. One patient with the third phase revealed 'type B'. Three patients with the last phase revealed all 'type C'. The MRI findings are well correlated with the histopathologic findings of LCH. Conclusion:The MRI classification could be useful for evaluating disease progression and therapeutic response of LCH.

Langerhans cell histiocytosis of long bones: MR imaging and complete follow up study

“…Lesion with high cellularity show high signal on T2w and contrast enhanced T1W images, where lesions with fibrosis show low signal on both image sequences. [8] In multilevel spinal lesions, MRI is useful in guiding biopsy by identifying the active from the inactive lesions. [9] CONCLUSION MRI is presently the most informative imaging tool in the management of bone LCH.…”

LANGERHANS CELL HISTIOCYTOSIS OF THE SCAPULA - DIAGNOSIS & TREATMENT OPTIONS

“…No specific clinical & radiographic presentation of LCH is described in the literature, and this poses a diagnostic dilemma for surgeons. [2][3][4][5] The bones are commonly affected, especially the flat bones, the spine and the long bones. Lesions such as "vertebra plana" or solitary lytic lesion of the skull may suggest LCH in children, while other lesions may be confused with malignant tumor or osteomyelitis.…”

Langerhans Cell Histiocytosis of the Clavicle

“…One of the most frequent presenting imaging features in adults is skeletal involvement with lytic lesions, 1 but clavicle lesions are extremely rare, especially in adults. 3 , 4 Till now, almost no related articles report characteristic imaging of LCH in clavicle in adults. We report 1 female adult patient with solitary clavicle EG, with a literature review.…”