technetium-tc-99m-medronate and Eosinophilic-Granuloma

Histiocytosis X is a disease of unknown origin which usually affects multiple organs, including the lung. The age of onset, the clinical course and the pattern of spread allow a distinction to be made between 3 varieties: Letterer-Siwe, Hand-Schüller-Christian and eosinophilic granuloma. The latter form, in adult patients, may predominantly or solely affect the lungs. The authors reviewed clinical, radiographic and CT findings of 7 adult patients with pulmonary eosinophilic granuloma, picked out of a series of 265 cases of interstitial lung pathology, diagnosed since 1973. Typical pulmonary involvement is bilateral, symmetrical and predominates in the upper areas. Honeycomb pattern was found in 1 patient at the onset of symptoms, and in 2 cases during the follow-up, without severe reduction in pulmonary volumes. Pneumothorax was observed in 3 cases and bone lesions in 2. CT added new and important informations such as presence, size and wall thickness of "cystic" lesions. New laboratory tests and bronchoalveolar lavage demonstrated minor diagnostic usefulness than radiological findings. The authors conclude by discussing such problems as prognostic factors and differential diagnosis.

Topics: Adolescent; Adult; Biopsy; Bone and Bones; Bronchoalveolar Lavage Fluid; Citrates; Citric Acid; Eosinophilic Granuloma; Follow-Up Studies; Gallium Radioisotopes; Histiocytosis, Langerhans-Cell; Humans; Lung; Lung Diseases; Male; Radionuclide Imaging; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Whole-Body Counting

Two 9-year-old patients with femoral bone lesions were referred to the authors' institution within a few days of each other. Both showed similar radiographic, magnetic resonance imaging, and scintigraphic findings. The radiographs showed osteolytic lesions in the right femoral diaphyses, and gadolinium-DTPA-enhanced magnetic resonance imaging revealed inhomogeneous enhancement. Tc-99m HMDP showed marked linear accumulation with relatively low central uptake in the right femoral shafts, and TI-201 scintigraphy showed considerable uptake corresponding to the area seen with Tc-99m HMDP. Histologic analysis confirmed eosinophilic granuloma in the first patient and Brodie's abscess in the second. The radiographic and scintigraphic findings in Brodie's abscess may be similar to those in eosinophilic granuloma.

Topics: Child; Eosinophilic Granuloma; Female; Femur; Gadolinium DTPA; Humans; Magnetic Resonance Imaging; Male; Osteomyelitis; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Thallium Radioisotopes

Topics: Child, Preschool; Eosinophilic Granuloma; Humans; Humerus; Male; Radionuclide Imaging; Radiopharmaceuticals; Spinal Diseases; Technetium Tc 99m Medronate; Thoracic Vertebrae; Tomography, X-Ray Computed

An 11-yr-old female presented with a 6-wk history of left upper lid tenderness and left eye lacrimation. Left lateral supraorbital mass and left preauricular lymph node were the only significant physical examination findings. On skull x-ray, a left frontal bone defect was noted. CT and MRI showed a soft-tissue mass in the area of the bone defect. Bone scintigraphy exhibited peripheral uptake within the central photon deficient area. With 201TI SPECT, high uptake was noted on early and delayed images. Diagnosis of eosinophilic granuloma was performed by biopsy. Since thallium uptake was seen in the area where photon deficiency was exhibited by 99mTc-MDP scintigraphy, we speculate that thallium SPECT could detect eosinophilic granuloma when radiographic skeletal survey or radionuclide bone scan are equivocal. It could also rule out multiple bone involvement and recurrence or regrowth after therapy.

Topics: Child; Eosinophilic Granuloma; Female; Follow-Up Studies; Frontal Bone; Humans; Magnetic Resonance Imaging; Radionuclide Imaging; Technetium Tc 99m Medronate; Thallium Radioisotopes; Tomography, X-Ray Computed

In 11 children with eosinophilic granuloma, the scintigraphic findings (bone scanning) were compared with those of radiography. All those lesions accompanied by clinically palpable soft tissue swelling were easily seen on the radiographs. Scintigraphic findings were most variable, even in children with polyostotic disease.

Topics: Adolescent; Child; Child, Preschool; Diphosphonates; Eosinophilic Granuloma; Female; Femur; Humans; Infant; Male; Radiography; Radionuclide Imaging; Ribs; Skull; Spine; Technetium; Technetium Tc 99m Medronate