Solitary eosinophilic granuloma of the ulna: Diagnosis on fine needle aspiration cytology

Abstract

Solitary eosinophilic granuloma is a part of the spectrum of Langerhans cell histiocytoses (LCH) which are rare diseases with varied clinical presentations. They comprise of three major overlapping syndromes: solitary eosinophilic granuloma (unifocal disease), Hand-Schueller-Christian disease (multifocal, unisystem), and Letterer-Siwe disease (multifocal, multisystem). A case of solitary eosinophilic granuloma of the ulna is presented here for its relatively uncommon incidence and the difficulty in making an accurate diagnosis based on the radiological picture alone. We hereby, emphasize the importance of a quick and reliable diagnosis based on fine needle aspiration cytology, and the need to consider the possibility of LCH in the differential diagnoses of a slide showing a large number of histiocytes and eosinophils, as in tuberculosis, Hodgkin′s disease, and other primary and metastatic bony lesions. Characteristic nuclear grooves and a large number of eosinophils help in clinching the cytological diagnosis.

Keywords

• Bone; FNAC; Langerhans cell histiocytosis; ulna.