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Langerhans cell histiocytosis (LCH) is a rare disease entity characterized by histiocyte infiltration of various organ systems with abroad spectrum of clinical manifestations and prognosis, ranging from benign and self-limiting to lethal. We report a case of a healthy 29-year-old male who presented with upper back pain that was unresponsive to over-the-counter analgesics. The painwas eventually attributed to a single lytic lesion at the posterolateral aspect of his seventh rib, consistent with LCH of the bone. Our patient's symptoms subsided without any surgical intervention apart from a biopsy that was performed for diagnostic purposes. His lytic lesion eventually regressed, and he has remained asymptomatic at follow-up. We provide a brief review of literature on diagnostic approach, guidelines, and treatment modalities for adults diagnosed with LCH of the bone, a rare diagnosis most frequently presenting with a common complaint such as back pain.

A perinephric abscess (PA) is an uncommon clinical entity. We present a case of a patient with aknown chronic perinephric hematoma, complicated by infection, subsequently developing a fistula to the adjacent descending colon. To the knowledge of these authors, there are no reported cases of perinephric abscess fistula formation with the descending colon.A 50-year old woman with multiple medical comorbidities presented with gram negative sepsis and was subsequently found to have a cyst on her left kidney. Following CT-guided biopsy, an iatrogenic hematoma was formed and subsequently became infected. Radiographic evaluation revealed fistula formation between the abscess and the adjacent descending colon. Conservative management resulted in closure of the fistula without the need for further surgical management.Perinephric abscess (PA) formation can result in significant morbidity and mortalitywith complications including sepsis, renal failure and fistula formation. We present a first case report in which a PA fistualized with the descending colon following percutaneous drainage.