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Geographic Skull

A 5 Y/O Female with Langerhans cell histiocytosis
.
Result of abnormal prolifration of langerhans histiocytes
Most frequently in childrens
Has extremely variable presentation:
• Letterer-Siwe (acute disseminated form): 10%
• Hand-Schuller-Christian (chronic disseminated form):20%
• Eosinophilic granuloma (isolated bone or lung involvement): 70%
.
Best diagnostic clue:
o Skull :sharply marginated lytic skull defect with beveled margins
o Mastoid :geographic destruction, soft tissue mass
o Brain :thick enhancing infundibulum

.

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Comment by Hertzanu Yancu on July 31, 2011 at 3:19am
Like lateral skull view
Comment by wesam a shamma on June 6, 2011 at 1:01pm
Good case
Comment by MOSAAB BABIKIR ABD ELLATIF AHMED on May 5, 2011 at 1:56pm

lateral skull x.ray showed:-

- large radiolucent  macrolobulated area at the tempro-occipital region,involved sphenoid bone and the clvarial tablets.

- widening the diploic area in clvarium of skull,with lucent part, and sclerotic part.

-all these consistant with bengin condition of bony lesion likely bone marrow tumer.

- sclerotic sphenoid bone.with thichening cortical bone no erosion. 

Comment by M.T Niknejad on April 28, 2011 at 6:02am
Thanks ...
Comment by radRounds Radiology Network on April 21, 2011 at 11:13pm
Nice case!  Congratulations - this case was featured!
Comment by Dr ritu lokhande on April 21, 2011 at 2:26am
Great description .thanx.

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