MyPACS.net: Radiology Teaching Files > Case 7639556

previously visited LANGERHANS HISTIOCYTOSIS WITH VERTEBRA PLANA
Contributed by: Dr Phillip Silberberg, Children's Hospital Omaha, Radiologist, Omaha Childrens, Creighton University and UNMC, Nebraska, USA.
Patient: 6 year old male
History: C/O neck pain and torticollis. C4 corpectomy
Images:[small]larger

Fig. 1: lateral Cervical spine Xray with reversed kyphosis at level of vertebra plana at C5 with retrolisthesis of C5 on C6.

Fig. 2: Sagital T2 spine MRI Spine. Note effacement of the thecal sac at the level of the vertebra plana and extradural mass at C5.

Fig. 3: Sagital T1 precontrast shows reversed cervical kyphosis with vertebra plana and extradural almost isotense mass at level. Normal discs and vertebra above and below.

Fig. 4: Sagital T1 post contrast shows reversed cervical kyphosis with vertebra plana. Enhancing focal extradural hyperintense mass at level. Normal discs and vertebra above and below.

Fig. 5: Axial T1 MRI Spine at normal vertebra above the vertebra plana.

Fig. 6

Fig. 7: NM Focal solitary " hot lesion on Tc 99m HDP bone scan

Fig. 8: Intraoperative fluoroscopy show fibular graft and anterior spinal fusion at level of the vertebra plana with correction of the reversed cervical kyphosis.

Fig. 9: First biopsy - fibrous tissue

Fig. 10: First biopsy - fibrous tissue

Fig. 11: First biopsy - fibrous tissue and lymphocytes

Fig. 12: Second biopsy - cartilage and bone

Fig. 13: Second biopsy - cartilage and bone

Fig. 14: Second biopsy - cartilage and fibrous tissue

Fig. 15: Second biopsy - intramedullary lymphocytes

Fig. 16: Second biopsy - bone
Findings: Pathology
Portions of dense fibrous tissue with focal lymphohistiocytic aggregate, C4 vertebral body.
Diagnosis: Langerhans histiocytosis.
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Additional Details:

Case Number: 7639556Last Updated: 04-08-2007
Anatomy: Spine and Peripheral Nervous System   Pathology: Neoplasm
Modality: Conventional Radiograph, MR, Nuc Med, PathologyAccess Level: Readable by all users
Keywords: langerhans histiocytosis cervical spine vertebral plana extradural mass

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