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Kim, Kim, Lyu, and Lee: Langerhans Cell Histiocytosis with Pancreatic Involvement: Imaging Findings Including Diffusion-Weighted Imaging
Case Report
Journal of the Korean Society of Magnetic Resonance in Medicine

Journal of the Korean Society of Magnetic Resonance in Medicine 2012; 16(3): 262-265.

Published online: 31 December 2012

DOI: https://doi.org/10.0000/jksmrm.2012.16.3.262

Langerhans Cell Histiocytosis with Pancreatic Involvement: Imaging Findings Including Diffusion-Weighted Imaging

Jun-Hwee Kim1, Myung-Joon Kim1, Chuhl Joo Lyu2, Mi-Jung Lee1

1Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University, College of Medicine, Korea.

2Department of Pediatric Oncology, Severance Children's Hospital, Yonsei University, College of Medicine, Korea.

Corresponding author: Mi-Jung Lee, M.D. Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University, College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel. 82-2-2228-7400, Fax. 82-2-393-3035, mjl1213@yuhs.ac

Received 10 August 2012       Revised 19 December 2012       Accepted 2 January 2013

Copyright © 2012 Korean Society of Magnetic Resonance in Medicine

Abstract

Langerhans cell histiocytosis (LCH) can affect many different organs. However, LCH with pancreatic involvement is very rare with a few reports about imaging findings. We present a case of multisystemic LCH with pancreatic involvement in a five-week-old infant. Pancreas lesion showed hypoechoic on ultrasonography, low density with poor enhancement on CT, and restricted diffusion on diffusion-weighted imaging. Although LCH with pancreatic involvement is rare, LCH should be considered in the differential diagnosis of pancreatic mass in children.

Keywords: Langerhans cell histocytosis, Pancreas, Diffusion-weighted imaging

Figures and Tables

Fig. 1
5-week-old male infant with granulomatous skin lesions.
a. Abdominal sonograph showing a round hypoechoic mass (arrow) in the uncinate process of the pancreas.
b. Doppler sonograph showing internal vascularity in the pancreatic lesion (arrow).
c. Axial image of the abdominal CT scan showing a round lesion with low attenuation and poor enhancement at the uncinate process (arrow) of the pancreas.
d-f. Abdominal MRI showing a solid mass (arrow) with low signal intensity on the T1-weighted image (d) and intermediate signal intensity on the T2-weighted image (e). DWI showing the lesion as high signal intensity on the b-value 1000 sec/mm2 image (f), suggestive of diffusion restriction.
g. Skin biopsy showing dermal infiltration of histiocytes suggestive of Langerhans cell histiocytosis.
jksmrm-16-262-g001

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