Roentgenographic Findings of Histiocytosis X in Long Bone

Abstract

Case 1 A girl, ten years old, had pain and swelling in her right arm. Roentgenograms revealed marked destruction of the right humerus, medullary cavity was destroyed as like as so called “hole within hole”, cortex was distinctly thinned and partially broken and moderate periosteal new bone formation was recognized. These findings were quite mimic to Ewing's sarcoma, but examinations such as angiogram, blood examination, open biopsy showed no malignant findings. Her course of illness was very good and almost healed without any specific treatment.Case 2 A girl, two and one-third years old, walked with a limp. X ray findings of her left femur were almost as like as case 1. But diagnosis of Hand-Schuller-Christian disease was made easily because of her general findings. They were exophthalmus, diffuse papular eruption, enlargement of the liver and right external ear canal occulsion by the granulation tissue. After curettage of the bone, chemotherapy and steroid treatment were used, her course was good and recently examination showed no subjective findings.Case 3 A boy, seven years old, had pain in his left arm. X ray findings showed well defined oval rarefaction in the middle part of the left humerus. Medullary cavity was expanded from inside, cortex was thinned but little periosteal new bone formation was presented. These findings simulated to solitaly bone cyst. But we diagnosed this case for histiocytosis X, because the lesion was not located in the distal or proximal part of the long bone and bone destruction and formation were mixedly noted at the same time, and the diagnosis was proved histologically. He had gained full recovery after curettage and bone graft.