Photopenic Area Visualized on Bone Scintigraphy in a Patient With Eosinophilic Granuloma

A 2-year-old boy was evaluated at the authors' institution for an episode of right shoulder pain. Radiographs showed osteolytic changes in the right humerus, and his bone scintigram showed abnormal accumulation with a photon-deficient area in the right humerus. Histologic findings of a bone biopsy revealed no malignant cells. The patient was diagnosed with osteomyelitis and followed accordingly. One month later, he could neither walk nor sit down. At that time his thoracic CT revealed an osteolytic mass in the tenth thoracic vertebra, and his bone scintigram showed a cold defect at the same location. Exploratory surgery was performed, and histologic findings revealed eosinophilic granuloma of the thoracic spine.