Pineal gland involvement in Erdheim-Chester disease detected on 18F-FDG PET-CT imaging: a case report and review of literature

Erdheim-Chester disease (ECD) is a rare non-Langerhan's cell histiocytosis affecting multiple organ systems. The most common systemic manifestations are bone lesions, infiltration of the pituitary stalk sometimes leading to diabetes insipidus, pulmonary fibrosis, cardiac failure and exophthalmus. Neurological symptoms as the first clinical manifestations of ECD have been reported in less than one third of cases. We report a rare presentation of a patient of ECD on 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography which revealed abnormal 18F-FDG accumulation in the region of pineal gland, pericardium and bilateral distal tibiae.