5. Conclusion
These cases emphasize the importance of multimodality approaches,
highlights the role of the 18F-FDG PET/CT to detect
rare or unusual HCL involvement and to drive biopsy. Although only small
series of patients have been reported in the literature, atypical
presentation in HCL is not uncommon and represents a significant
diagnostic challenge in routine practice. 18F-FDG
PET/CT should become more prominent in the future at the time of
diagnosis and in monitoring response in cases of unusual or atypical
presentation. However, the pathological mechanism of this bone
involvement with such low bone marrow involvement remains unclear.