Percutaneous Techniques for the Diagnosis and Treatment of Localized Langerhans-Cell Histiocytosis (Eosinophilic Granuloma of Bone)* by ALAN W. YASKO,

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Percutaneous Techniques for the Diagnosis and Treatment of Localized Langerhans-Cell Histiocytosis (Eosinophilic Granuloma of Bone)* by ALAN W. YASKO, CHRISTINA V. FANNING, ALBERTO G. AYALA, C. HUMBERTO CARRASCO, and JOHN A. MURRAY J Bone Joint Surg Am Volume 80(2): February 1, 1998 ©1998 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1 Skeletal distribution of the osseous lesions of Langerhans-cell histiocytosis in the present series. ALAN W. YASKO et al. J Bone Joint Surg Am 1998;80: ©1998 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2-A Cytological smear of material obtained with fine-needle aspiration, demonstrating histiocytes with abundant cytoplasm and grooved or infolded eccentric nuclei, characteristic of Langerhans histiocytes. ALAN W. YASKO et al. J Bone Joint Surg Am 1998;80: ©1998 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2-B Histological section of a specimen obtained with core-needle biopsy, demonstrating large pale-staining histiocytes (arrows) with eccentric nuclei and nuclear grooves. ALAN W. YASKO et al. J Bone Joint Surg Am 1998;80: ©1998 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-A: Radiograph indicating a diagnosis of Langerhans-cell histiocytosis (arrow) of the proximal part of the femur in a ten-year-old girl who had a three-month history of pain in the left thigh and an associated limp. ALAN W. YASKO et al. J Bone Joint Surg Am 1998;80: ©1998 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-B: Radiograph showing complete healing of the femoral lesion by four months. ALAN W. YASKO et al. J Bone Joint Surg Am 1998;80: ©1998 by The Journal of Bone and Joint Surgery, Inc.

Fig. 4-A Plain radiograph demonstrating a destructive lesion of the superior pubic ramus (arrows) in a ten-year-old boy who was seen because of inguinal pain and a limp of one month's duration with no history of injury. ALAN W. YASKO et al. J Bone Joint Surg Am 1998;80: ©1998 by The Journal of Bone and Joint Surgery, Inc.

Fig. 4-B Computerized tomography scan delineating the extent of cortical thinning and expansion (arrow). ALAN W. YASKO et al. J Bone Joint Surg Am 1998;80: ©1998 by The Journal of Bone and Joint Surgery, Inc.

Fig. 4-C: Radiograph showing healing four weeks after injection of 125 milligrams of methylprednisolone. ALAN W. YASKO et al. J Bone Joint Surg Am 1998;80: ©1998 by The Journal of Bone and Joint Surgery, Inc.

Fig. 4-D: Radiograph showing remodeling of the pubis eight months after treatment. ALAN W. YASKO et al. J Bone Joint Surg Am 1998;80: ©1998 by The Journal of Bone and Joint Surgery, Inc.

Fig. 5-A: Radiograph showing a permeative lesion of the distal part of the humerous associated with a solid, uninterrupted periosteal reaction (arrows), suggestive of osteomyelitis or Langerhans-cell histiocytosis, in a nine-year-old boy who had a one-month... ALAN W. YASKO et al. J Bone Joint Surg Am 1998;80: ©1998 by The Journal of Bone and Joint Surgery, Inc.

Figs. 5-B, 5-C, and 5-D: Radiographs made six weeks, sixteen weeks, and two years after treatment, demonstrating progressive healing and bone-remodeling. ALAN W. YASKO et al. J Bone Joint Surg Am 1998;80: ©1998 by The Journal of Bone and Joint Surgery, Inc.

Figs. 5-B, 5-C, and 5-D: Radiographs made six weeks, sixteen weeks, and two years after treatment, demonstrating progressive healing and bone-remodeling. ALAN W. YASKO et al. J Bone Joint Surg Am 1998;80: ©1998 by The Journal of Bone and Joint Surgery, Inc.

Figs. 5-B, 5-C, and 5-D: Radiographs made six weeks, sixteen weeks, and two years after treatment, demonstrating progressive healing and bone-remodeling. ALAN W. YASKO et al. J Bone Joint Surg Am 1998;80: ©1998 by The Journal of Bone and Joint Surgery, Inc.