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case_images: (A) Anterior and posterior bone scintigraphy images revealed marked uptake of the radiotracer in the right humerus and left femur, indicated by arrows, alongside an area of reduced uptake in the left skull, marked by an arrowhead. (B) Follow-up images taken 18 months later exhibited noticeable changes in the radiotracer uptake within these lesions. (C, D) Histological analysis of the proximal humerus section, stained with hematoxylin and eosin, displayed a proliferation of histiocytes with folded nuclei and a scarcity of mitotic figures. [(C),x40; (D),x100].
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case_images: A follow-up bone scan 18 months later revealed new metabolically active lesions; however, some pre-existing lesions had improved slightly ( Figure 1 ).
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case_images: (A) Bone scintigraphy (anterior and posterior) demonstrated avid radiotracer uptake in the T11 vertebral body (arrow). (B) Axial CT imaging identified bone destruction at T11 with partial cortical breach and an adjoining paravertebral soft tissue mass that contributed to spinal canal stenosis. (C) Lateral radiograph of the spine demonstrated osteolytic damage and collapse of the T11 vertebral body (arrow). (D-G)
  18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT showed extensive destruction of the T11 vertebral body (thin arrow) and intense FDG uptake (maximum standardized uptake value of 8.8) in the surrounding soft tissue (thick arrows) [(D), MIP image; (E), CT; (F), PET; and (G), fusion].
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case_images: PET/CT showed bone destruction and abnormal metabolism in the T11 vertebral body and thickening of the surrounding soft tissue. Pathological examination of a biopsy specimen confirmed LCH ( Figure 2 ).
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case_images: (A) Bone scintigraphy (anterior and posterior) displayed a region in the right temporal bone with high peripheral and low central radiotracer uptake (arrow). (B) Imaging conducted 1 year later revealed a more even distribution of radioactivity in the same area.
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case_images: Figure 3 ). Follow-up imaging 1 year later showed a lower and more uniform concentration of radioactivity in the corresponding area.
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case_images: (A) Bone scintigraphy (anterior and posterior) demonstrated avid radiotracer uptake in the lower cervical spine (arrow). (B) CT depicted significant structural damage to the C7 vertebral body, right pedicle, and posterior elements. (C) Magnetic resonance imaging (MRI) showed signal change in the C7 body and posterior elements with associated spinal canal stenosis and cord compression (arrow). (D) A follow-up bone scan 11 months later showed disappearance of uptake in the cervical spine. (E) CT showed persistent bone destruction. (F) MRI showed improvement in spinal canal stenosis.
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case_images: C7. CT and MRI showed persistent osteolytic destruction but improvement in spinal canal stenosis ( Figure 4 ).
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