Article Figures & Data
Figures
- Fig 1.
Lateral radiograph shows large circumscribed lytic lesion in frontal bone.
- Fig 2.
Anteroposterior radiograph demonstrates a large frontoparietal lytic lesion suggestive of diffuse spreading type.
- Fig 3.
Frontal radiograph shows a lytic lesion with a sclerotic margin.
- Fig 4.
A, Contrast-enhanced axial CT scan shows peripherally enhancing epidural collection in left frontal region with bone defect and scalp swelling. B, Axial CT with a bone window shows left frontal calvarial defect destroying both inner and outer tables. Note the bony sequestration.
- Fig 5.
Contrast-enhanced coronal CT scan shows right frontal epidural collection with subgaleal soft tissue. Note the circumscribed area of encephalomalacia of CSF attenuation.
- Fig 6.
A, Coronal CT scan demonstrates a peripherally enhancing epidural collection over parietal region, crossing the midline associated with subgaleal soft tissue. On subsequent imaging, superior sagittal sinus showed no evidence of filling defect. The sinus tract is seen. B, Coronal bone window demonstrates destruction of right parietal bone.
- Fig 7.
A, Axial T1- weighted MR image shows a predominantly isointense lesion in the right parietal bone. The hypointensity within it is suggestive of sinus tract. A streak of hyperintensity is also seen in the epidural region. B, Axial T2-weighted MR image shows the hypointense lesion in the right parietal bone. The epidural collection is hyperintense. C, Axial T1-weighted contrast-enhanced MR image shows diffuse enhancement of the calvarial lesion.
- Fig 8.
Histopathologic analysis (Ziehl Nelsen stain) of surgical specimen obtained from the lesion showing multiple epitheloid granulomas with central caseation and palisade epitheloid cells (white arrowhead) with Langerhans giant cells (white arrow). Magnification ×100.
Tables
Characteristic Number of Cases (%) Age (y): 0–10 2 (4.7) 11–20 26 (61.9) 21–30 12 (28.5) 31–40 2 (4.7) >41 0 (0) Sex: Male 28 (66) Female 18 (33) Feature Number of Cases (%) Scalp swelling 39 (92.8) Sinuses 22 (52.3) Seizures 4 (.095) Meningitis 2 (.047) Duration of Presenting Symptoms (mo) Sinuses: 0–1 8 (19) 2–3 27 (64) 4–6 4 (9) >6 3 (7) Feature Number of Cases (%) Location: Parietal bone 22 (52.3) Frontal bone 14 (33.3) Occipital bone 6 (14.2) Plain radiographic finding: Circumscribed lesions 31 (73.8) Sclerotic lesions 3 (7) Diffuse spreading 8 (19) Subgaleal soft tissue 39 (92.8) CT scan finding: Extradural soft tissue 22 (52) Calvarial destruction 36 (85.7) Parenchymal involvement 5 (11.9) Subgaleal soft tissue 38 (90) Sinus formation 22 (52.3)
