Magnetic resonance imaging of thickened pituitary stalk proceeding to Langerhans cell histiocytosis in a child

Australasian Radiology
A M Halefoglu

Abstract

Magnetic resonance imaging has shown isolated pituitary stalk thickening in certain cases of idiopathic or secondary central diabetes insipidus (DI) due to infiltrative processes. We present a 4-year-old boy who was initially diagnosed as having central DI. The MRI showed isolated pituitary stalk thickening with prominent homogeneous contrast enhancement. The remaining findings on MRI were within normal limits. The patient's personal and family history and laboratory and clinical findings were unremarkable; therefore, he was initially diagnosed as having idiopathic DI. Since central DI and isolated pituitary stalk thickening may be considered to be the first manifestations of Langerhans cell histiocytosis, we decided to follow up the patient. After 5 months, following the initial diagnosis, on skeletal X-ray survey, the patient did indeed develop multiple lytic skull lesions which, on biopsy, were histologically typical bone lesions of Langerhans cell histiocytosis.

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Citations

Dec 1, 2009·Best Practice & Research. Clinical Endocrinology & Metabolism·R CarpinteriA Giustina
Jan 30, 2008·Endocrinology and Metabolism Clinics of North America·Andrea GlezerMarcello Delano Bronstein
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Nov 21, 2009·Journal of Veterinary Internal Medicine·Rachel E PollardEdward C Feldman

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