Saturday 4 October 2014

Eosinophilic Granuloma Skull

A 14 y o male with left parietal swelling. Slightly tender, non progressive.

MRI brain FLAIR screening shows left parietal expansile lesion centred to bony calvarium. Lesion is lytic on limited axial CT sections (images not available)
Whole body screening within normal limits.
X ray chest within normal limits.

Here is the histopathology report of the lesion.

Gross specimen: multiple irregular soft to bony pieces of dull greyish tan tissue, together measuring 3x3x1.6cm. The entire tissue submitted for processing after de calcification of the bony spicules.

Microscopy: Fragmented bits of fibrotic connective tissue amidst which are seen scattered sheets and aggregates of mixed inflammatory cells consisting of numerous eosinophils few polymorphs and moderate number of lymphocytes and plasma cells. Amidst this cellular infiltrates are seen interspersed occasional histioyctic cells with smudged characteristic ? langerhan’s histiocytic cells. The cells have indistinct cytoplasmic margins. No epithelioid granulomas seen. There is no evidence of tuberculosis or parasitis aetiology. Section b shows osseous component with minimal inter trabercular areas showing similar infiltrates as described above under section A.

Diagnosis: histo pathological features are compatible with solitary Eosinophilic Granuloma.