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Case Reports
. 2010 Oct;25(4):164-7.
doi: 10.4103/0972-3919.78253.

Tc 99m bone scan and fluorodeoxyglucose positron emission tomography in evaluation of disseminated langerhans cell histiocytosis

Sait Sager  1 , Sabire Yilmaz, Gunes Sager, Metin Halac
Affiliations
Case Reports

Tc 99m bone scan and fluorodeoxyglucose positron emission tomography in evaluation of disseminated langerhans cell histiocytosis

Sait Sager et al. Indian J Nucl Med. 2010 Oct.

Abstract

Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder in which pathological langerhans cells accumulate in a variety of organs. Manifestations may include lung infiltrates, lymph node involvements, bone lesions, hepatic, hematopoietic and endocrine dysfunctions. In this case report we present fluorine-18 positron emission tomography (F-18 PET/CT) and bone scintigraphy findings of a 18-year-old male patient with disseminated LCH, mimicking multiple hypermetabolic metastatic lesions. Clinicians should be aware that LCH infiltrations can be seen as intense uptake and to differentiate infiltrations from other metastatic intense uptake with fluorodeoxyglucose PET/CT and bone scintigraphy, clinical and laboratory findings should be kept in mind.

Keywords: Bone scan; FDG PET/CT; Tc-99m MDP; langerhans cell histiocytosis.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Tc 99m MDP bone scan revealed increased activity in dorsal 2, dorsal 8, right second rib, left scapula, sternum and bilateral iliac bones (a and b, arrows)
Figure 2
Figure 2
PET/CT imaging revealed intense FDG uptake in dorsal 2, dorsal 8, right second rib, left scapula, sternum and bilateral iliac bones (a, MIP, b and c, axial PET images) which were litic in CT slices (d and e, axial CT images). Maximum standard uptake value of bone lesions was 9,6. In addition to bone lesions FDG uptake in left axillary lymph node with a maxium standard uptake of 5,4 (f, axial fusion image) and minimal FDG uptake in right upper lobe lung pulmonary nodule with a maxium standard uptake of 2,1 were seen (g, axial fusion image)
Figure 3
Figure 3
Histological findings of proliferating langerhans cells with intermingled eosinophils, neutrophils and lymphocytes in biopsy specimen (hematoxylin and eosin)
See this image and copyright information in PMC

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