Clinical characteristics and MRI manifestations of Langerhans cell histiocytosis in children
Objective To investigate the MRI and clinical characteristics of Langerhans cell histiocytosis(LCH)of pituitary gland in children.Methods We conducted a retrospective analysis the MRI data of the 23 children with pituitary LCH confirmed by pathological from November 2014 to August 2023,including 12 males and 11 females with an average age of 1 year to 12 years 6 months(6.72±3.33 years old).The lesion location,pituitary height,presence of neurohypophysis,pituitary stalk shape,size,pituitary reinforcement,and pituitary/pineal concomitant lesions were observed.The MRI findings of pituitary LCH were summarized.Results The main reason for the first visit was diabetes insipidus,and other symptoms were head mass in 2 cases,head tenderness in 1 case and neck mass in 1 case.Only pituitary was involved in 16 cases,and the rest were multisystem involved.Craniofacial bones were often involved outside the pituitary,and lungs and ribs were rarely involved.The adenohypophyseal was significantly depressed and thin in 1 case and full/bulging in 4 cases.No neurohypophysial hypersignal was found in all cases.The adenohypophyseal was significantly depressed and thin in 1 case and full/bulging in 4 cases.No neurohypophysial hypersignal was found in all cases.There were 13 cases of pituitary stalk thickening,2 cases of fine,1 case of funnel line stenosis,the upper segment nodular thickening,7 cases without obvious thickening/fine.The pituitary was enhanced uniformly after enhancement.There were 3 cases with rathke cyst/remnant cavity and 2 cases with pineal cyst.Conclusion The MRI manifestations of pituitary LCH in children have certain characteristics,which is helpful for diagnosis.