Twenty-six cases of lipid (cholesterol) granulomatosis, Erdheim-Chester Disease (ECD), have been described in the literature to date. A new case of ECD in a 33-year-old man with an unusual presentation of exudative ascites following a four year history of abdominal pain is reported. The radiographic and bone scan findings in this disease have been established and Ga-67 scan findings are reported. The Tc-99m sulphur colloid bone marrow and In-111 chloride scan findings are presented.