Pituitary stalk thickening on magnetic resonance imaging as a first sign of Langerhans cell histiocytosis in an adult

Magnetic resonance imaging (MRI) should be performed in the diagnostic workup of central type diabetes insipidus patients to investigate the hypothalamo-pituitary region for a possible thick pituitary stalk. Herein, we presented a 31-year-old male patient who was initially diagnosed as having central diabetes insipidus. MRI revealed isolated pituitary stalk thickening with prominent homogenous contrast enhancement. The remaining findings on cranial MRI were within normal limits for the patient. But a couple of months later he developed some airway symptoms which required a high resolution computed tomography (HRCT) examination. This revealed some suspicious findings in terms of Langerhans’ cell histiocytosis (LCH) and following open lung biopsy the patient was diagnosed as having LCH.