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Pituitary Hypophysits in Langerhans Cell Histiocytosis

Case Detail

Anatomy: Brain-Spine
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Benign
Created: over 7 years ago
Updated: over 4 years ago
Tags: PEDS
Modality/Study Types: MR
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Child with polydipsia.

Case Images


Pituitary Apophysitis Langerhans Cell Histiocytosis


MR – Sagittal high resolution pre and post gadolinium T1 images of the sella turcica show loss of normal T1 hyper intensity of the neurohypophysis and diffuse hyper enhancement of the pituitary stalk and infundibulum with focal thickening.


The hypothalamic-pituitary system is involved input to half of pediatric LCH, particularly in those with craniofacial or systemic disease. Central diabetes insidious may antedate the diagnosis of LCH and usually develops within a year of diagnosis. Pathogenesis may relate to an autoimmune process that involves antibodies reacting against vasopressin, LCH-infiltration and/or scarring in the hypothalamic pituitary area. On MR, absent posterior pituitary T1 bright spot, thickening of the pituitary stalk (>3.5 mm) and hyper enhancement of the stalk and/or infundibulum/hypothalamic eminence are seen with neurohypophyseal dysfunction.


Machine M, Arico M, Genovese E, et al. MR of the hypothalamic-pituitary axis in Langerhans cell histiocytosis. AJNR (1992); 13: 1365-1371.

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