Imaging of Hand-Schüller-Christian Syndrome by a Monoclonal Antibody

PURPOSEMultifocal eosinophilic granuloma (Hand-Schüller-Christian syndrome) consists of localized lesions of histocytosis X originating from proliferating Langerhans' cells involving male children and young adults. MATERIALSThe authors present the first case of multifocal eosinophilic granuloma that was imaged by Tc-99m monoclonal antibody BW250/183 recognizing NCA-95 antigen on granulocytes. A 30-year-old man had a diagnosis of histiocytosis X for 16 years. RESULTSAll active known lesions were visualized. The previous radiotherapy fields were also accurately demonstrated as areas with no antibody accumulation. Bone marrow biopsy taken 30 hours after injection showed no infiltrations, but mild hypoplasia suggesting chronic disease was demonstrated. Retrospectively, the authors performed digital autoradiography from tissue samples and found specific targeting with the same BW250/183 antibody. CONCLUSIONTheir results indicate that antibody targeting is possible in multifocal eosinophilic granuloma, probably even allowing radioimmunotherapy.