eosinophilic granuloma

60-80% of histiocytosis X
age 5 - 10 yrs
presentation: bone pain, local swelling, irritability
bones
- 50 - 75% solitary / monostotic
- skull/mandible (50%): "punched-out" lucencies, "hole within a hole", "button sequestrum", "floating teeth"
- spine/pelvis (25%): vertebra plana (most common pediatric cause)
- long bones (15%): medullary lucency +/- thin sclerotic rim
lungs
- involved in <10%, signals worse prognosis
- apical reticulonodular infiltrates
- honeycomb lung

Charles E. Kahn, Jr., MD - 2 February 1995
Last updated: 1 October 2013