case_images: PMC11167066_01
case_images: a A coronal section of the computerized tomography of abdomen and pelvis showing heterogenous liver parenchymal enhancement, duodenitis, and diffuse pancolitis with colonic wall edema. b A sagittal section of the MRI of the brain demonstrating enhancement of the pituitary (circle) suggesting pituitary hypophysitis.
case_images: crg-2024-0018-0001-538794_f01.jpg
case_images: PMC11167066_01_crg-2024-0018-0001-538794_f01.jpg
case_images: F1
case_images: Computed tomography (CT) of the abdomen and pelvis with contrast illustrated diffusely heterogenous liver parenchymal enhancement without ductal dilatation, duodenitis, and diffuse colonic thickening concerning pancolitis (shown in Fig. 1a). Brain magnetic resonance imaging (MRI) with contrast revealed abnormal enhancement and thickening of the pituitary infundibulum and stalk most consistent with lymphocytic hypophysitis (shown in Fig. 1b).
case_images: Pathology results from the liver biopsy. a Bile duct infiltrated by atypical histiocytic cells (arrow) as shown on H&E stain. These cells are positive for CD1a (b), S100 (c), and BRAFV600E (d) confirming the diagnosis of LCH.
case_images: crg-2024-0018-0001-538794_f02.jpg
case_images: PMC11167066_01_crg-2024-0018-0001-538794_f02.jpg
case_images: F2
case_images: Tissue stained positive for CD1a and S100, markers of Langerhans cells, and BRAFV600E-mutated protein, commonly found in various malignancies (shown in Fig. 2).