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  • The Internet Journal of Radiology
  • Volume 2
  • Number 1

Original Article

FDG PET Imaging Of Hypothalamic Langerhans Cell Histiocytosis

E Lin

Keywords

f-18 fluorodeoxyglucose, langerhans cell histiocytosis, medicine, positron emission tomography, radiology

Citation

E Lin. FDG PET Imaging Of Hypothalamic Langerhans Cell Histiocytosis. The Internet Journal of Radiology. 2000 Volume 2 Number 1.

Abstract

A case of intense FDG uptake in the hypothalamus secondary to Langerhans cell histiocytosis involving the hypothalamus is presented.

 

Case Report

A 24-year woman with Langerhans cell histiocytosis (LCH) had a positron emission tomography (PET) scan (Fig. 1) demonstrating intense F18-fluorodeoxyglucose (FDG) uptake in the hypothalamus. A contrast-enhancing hypothalamic mass was demonstrated by magnetic resonance imaging (MRI) (Fig. 2), corresponding exactly to the area of intense FDG uptake. This mass had been stable for two years and was thought to represent LCH involving the hypothalamus. LCH can show significant gadolinium enhancement on MRI (1, 2) and the hypothalamus is the most common area of brain involvement in LCH (3). The appearance of LCH on FDG PET has not been previously described in any area of the body. This case illustrates that LCH involving the brain can demonstrate intense FDG uptake, potentially mimicking high-grade gliomas. Correlation with patient history and knowledge of the pattern of LCH involvement in the brain is necessary to avoid misdiagnosis.

Figure 1
Figure 1: Coronal image from a PET scan performed with 11.0 mCi (407 MBq) of FDG demonstrates intense FDG uptake in the hypothalamus (arrow).

Figure 2
Figure 2: Coronal T1-weighted (TR 537, TE 20) gadolinium-enhanced MRI demonstrates focal hypothalamic enhancement (arrow), corresponding to the area of increased FDG uptake.

References

1. George JC; Edwards MK, Smith RR, Provisor AJ: MR of intracranial Langerhans cell histiocytosis. J Comput Assist Tomogr 18 (2):295, 1994.
2. Langerhans cell histiocytosis involving the corpus callosum and cerebellum: gadolinium-enhanced MRI. Neuroradiology 37 (4):289, 1995.
3. dÂ’Avella D; Giusa M; Blandino A, et al: Microsurgical excision of a primary isolated hypothalamic eosinophilic granuloma: Case report. J Neurosurg 87(5): 768, 1997.

Author Information

Eugene C Lin, M.D.
Assistant Professor, Radiology, Nuclear Medicine, University of Colorado

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