SARCOIDOSIS AND LCH Non neoplastic systemic diseases may also affect bone marrow, most notably sarcoidosis and Langerhans cell histiocytosis. Sarcoidosis is an inflammatory disorder characterized by noncaseating granulomas that can be found anywhere throughout the body. Radiographs may be normal or demonstrate lacelike osteolysis and rarely osteosclerotic lesions. It usually involves the small bones and only rarely affects long bones or the axial skeleton. MRI findings may be variable with focal ill-defined or well circumscribed lesions, as well as patchy and confluent infiltration (Fig. 11).49 Langerhans cell histiocytosis (LCH) is a spectrum of disease with idiopathic proliferation of histiocytes and granulation formation that can have focal or systemic manifestations. Focal and diffuse forms most commonly present with osseous lesions. Disseminated disease may demonstrate generalized osteopenia. As with other marrow replacement disease, LCH demonstrates nonspecific signal abnormality, hypointense signal on T1 and hyperintense signal on T2-weighted images. Even though historically LCH has been diagnosed and followed with conventional radiography or scintigraphy, MRI may helpful in demonstrating bone marrow abnormality earlier in the disease process.50
Posted on: Thu, 13 Nov 2014 15:55:24 +0000
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