The variable roentgenographic appearance of idiopathic histiocytosis

The radiographic characteristics of histiocytosis X. A study of 29 cases that involve the jaws

The purpose of this study was to provide an objective analysis of the radiographic characteristics of histiocytosis X as it affects the jaws. The original radiographs of 29 cases were reviewed independently and objectively by three observers. The results suggest that seven characteristics, either alone or in combination, are useful in the identification of histiocytosis X. These include the appearance of solitary "intraosseous" lesions, the multiplicity of "alveolar bone" lesions, the "scooped-out" effect in the alveolar process, the well-defined periphery, sclerosis in the alveolar bone lesions, periosteal new bone formation, and slight root resorption.

Histiocytosis X: an ophthalmological review

Of 76 children with histiocytosis X 18 had orbital involvement, and four developed additional neuro-ophthalmic complications. No instance of intraocular involvement was detected. Among those patients with ophthalmic involvement the main problems were bilateral or unilateral proptosis, ptosis, papilloedema, optic atrophy, and seventh nerve palsy. Only one patient developed a severe visual defect. Management of the ophthalmological complications depends not only on the extent of the orbital disease but also on the degree of systemic involvement. Overall management by a paediatric oncologist is mandatory.

Orbital histiocytosis on computed tomography

Computed tomography (CT) findings in two patients with orbital histiocytosis are described. The main features are (a) replacement of bone by soft tissue, which has an absorption value of approximately 40 Hounsfield units (HU) and is not contrast-medium enhanced; (b) bone expansion at the rim of the lesion; (c) a large intraosseous component and a small extraosseous part; and (d) absence of calcification or periosteal reaction.

Eosinophilic granuloma of bone

Forty-three patients with histologically proven Histiocytosis X localized to bone at presentation have been reviewed. Thirty-six patients presented with solitary bone lesions and 31 have healed without complication with a mean follow-up of 10 years. The remaining five patients developed polyostotic disease, three exhibiting either pulmonary lesions or diabetes insipidus. Seven patients presented with multiple bone lesions and six of them developed other bone lesions. Four of these patients also showed some of the features of Hand-Schüller-Christian disease. An increase in size of the presenting bone lesion within a few months of biopsy heralded the subsequent development of further bone or soft tissue lesions and was the only feature of prognostic value.

Probably congenital histiocytosis X with unusual radiographic findings in a 7-week-old infant

A 7-week-old infant who probably had congenital histiocytosis X of the Letterer-Siwe type, and who showed mesomelic involvement of the long bones, is reported. Although skeletal changes are common in histiocytosis of the Letterer-Siwe type, very early appearance and localisation of these changes is unusual.

Histiocytosis X: current concepts and a report of two cases

The current concepts of histiocytosis X are discussed, and the literature concering this rare disease of obscure aetiology reviewed. Two case reports of histiocytosis X presenting in similar sites in young children of similar ages, but with markedly different courses, are presented. The importance of early recognition of the disease, particularly by the dental surgeon who may see the first oral signs, is stressed. Attention is drawn to the danger of misdiagnosing the oral signs of histiocytosis X, particularly as periodontal disease. The possible aetiologies are examined and current treatment regimes discussed.