Halefoglu A M
Department of Radiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
Australas Radiol. 2006 Apr;50(2):175-8. doi: 10.1111/j.1440-1673.2006.01549.x.
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.
磁共振成像显示，在某些特发性或继发性中枢性尿崩症（DI）的浸润性病例中，存在孤立性垂体柄增厚。我们报告一名4岁男孩，最初被诊断为中枢性尿崩症。MRI显示孤立性垂体柄增厚，伴有明显的均匀强化。MRI的其余表现均在正常范围内。患者的个人史、家族史以及实验室和临床检查结果均无异常；因此，他最初被诊断为特发性尿崩症。由于中枢性尿崩症和孤立性垂体柄增厚可能被视为朗格汉斯细胞组织细胞增多症的首发表现，我们决定对该患者进行随访。在最初诊断后的5个月，进行骨骼X线检查时，患者确实出现了多个溶骨性颅骨病变，活检显示为朗格汉斯细胞组织细胞增多症典型的组织学骨病变。
