Eosinophilic granuloma presenting with local osteolysis in an adult lumbar spine.

We report an adult patient with eosinophilic granuloma presenting as a local lytic lesion of a vertebral body in the lumbar spine. The patient was a 48-year-old man with a 2-month history of low back pain and numbness in both legs. On plain X-ray, a lytic lesion of the L2 vertebral body was noted. On MRI, the lesion exhibited low-intensity change on T(1)-weighted images, high-intensity change on T(2)-weighted images, and was homogeneously enhanced by gadolinium. The lesion was surgically treated by curettage and iliac bone grafting using a retroperitoneal approach. Histologically, a specimen obtained at the time of surgery was found to be eosinophilic granuloma. We present details of this extremely rare case and review the literature.