title: Pineal gland abnormalities in Langerhans cell histiocytosis.
abstract: BACKGROUND
  The most common types of central nervous system (CNS) disease in Langerhans cell histiocytosis (LCH) comprise involvement of the hypothalamic-pituitary region (HPR) and neurodegenerative changes in the cerebellum, basal ganglia or pons. In the review process of magnetic resonance images (MRI) from 129 LCH patients a high frequency of cysts within or large pineal glands was noted by chance.
  
  
  METHODS
  To prove whether this observation was specific for LCH or not, we compared MRI findings of the HPR in LCH patients with a control group of 55 non-LCH patients with the same age and sex distribution.
  
  
  RESULTS
  In LCH patients, the pineal gland was significantly larger and also the number of pineal cysts was significantly higher as compared to the control group. No difference was found regarding the size or frequency of cystic changes between patients who had received chemotherapy prior to the MRI and untreated patients. In the LCH patients, we further found a significant correlation of pineal gland enlargement with involvement of the HPR, but not with neurodegenerative changes. Analysis of melatonin (the principal hormone of the pineal gland) levels in 24 hr urine in 14 LCH patients did not reveal a melatonin deficiency or overproduction in the LCH group as compared to 6 normal controls.
  
  
  CONCLUSIONS
  The pineal gland is another site of possible CNS involvement in LCH. LCH CNS patients did not show an overt disturbance in melatonin levels. The role of the pineal gland in CNS LCH remains to be defined.
authors.affiliation: Children's Cancer Research Institute, St. Anna Children's Hospital, Vienna, Austria. grois@stanna.at
authors.forename: N
authors.initials: N
authors.lastname: Grois
authors.forename: H
authors.initials: H
authors.lastname: Prosch
authors.forename: F
authors.initials: F
authors.lastname: Waldhauser
authors.forename: M
authors.initials: M
authors.lastname: Minkov
authors.forename: G
authors.initials: G
authors.lastname: Strasser
authors.forename: M
authors.initials: M
authors.lastname: Steiner
authors.forename: E
authors.initials: E
authors.lastname: Unger
authors.forename: D
authors.initials: D
authors.lastname: Prayer
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006646:Histiocytosis, Langerhans-Cell / Q000473:pathology* / Q000628:therapy / Q000652:urine; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008550:Melatonin / Q000652:urine; D010870:Pineal Gland / Q000002:abnormalities / Q000473:pathology*
chemical_list: D008550:Melatonin