PMC5733184_01
Histology of left iliac bone biopsy (a-b), X-ray of the mandible with lytic lesion (c), and bone scintigraphy images (d-e).
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CT-guided needle biopsy was done, and histology (Figures 1(a) and 1(b)) and immunohistochemical analysis were immunoreactive for S100 and CD1a, consistent with Langerhans cell histiocytosis. While on treatment with cytarabine, he experienced jaw pain with enlargement of the lesion (Figure 1(c)). His jaw pain persisted, and bone scintigraphy (Figures 1(d) and 1(e)) showed new lesions in the distal right humerus, sternum, and right midclavicle.
PET CT imaging without metabolic activity in stable lesions and no new lesions. (a) Right clavicle, (b) mandible region, (c) hip and pelvis, (d) pelvis and sacroiliac joint, and (e) sternum.
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The bone pain resolved, and three months later, his bone lesions remained stable without metabolic activity on follow-up PET CT imaging (Figure 2) without new lesions.