PMC9992715_01
99mTc-MDP SPECT revealed a lesion with high uptake of 99mTc-MDP in the left fifth rib (indicated by red arrows).
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F1
A lesion with high uptake of 99mTc-MDP in the left fifth rib was revealed and no other lesions were found in the image (Figure 1).
PET/CT image showed obvious osteolytic bone destruction and abnormal FDG uptake in the right fifth rib with local soft tissue mass formation (indicated by arrows).
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F2
PET/CT was performed for staging. PET/CT image showed obvious osteolytic bone destruction and abnormal FDG uptake (SUVmax 14.5) in the left fifth rib with local soft tissue mass formation (Figure 2).
(A-C) Hematoxylin and eosin stain demonstrates histiocytes with pale cytoplasm and reniform nuclei. (D) CD1a, (E) Langerin, and (F) S-100.
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F3
By immunohistochemistry stain, the cells of surgical specimens were positive for CD1a, S-100, and Langerin, which confirmed the diagnosis of LCH (Figure 3).
Images before and after surgery. (A) Prior to surgery, showing an osteolytic lesion in the left fifth rib. (B) One month after surgery, part of the fifth rib was excised with the lesion.
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F4
The relevant images are shown in Figure 4.