Lymphoid "hypophysitis" with end organ insufficiency

A clinically hypothyroid patient had bi-lateral adrenal cortical atrophy and an extraordinary lesion of the pituitary gland. The parenchyma of the adenohypophysis was extensively replaced by a predominantly lymphocytic infiltrate with formation of nodules, many of which had pale germinal centers. There were areas of hyalinization with interstitial fibrosis and mildcapsular thickening. A similar lesion of the adenohypophysis has been reported previously, but without the evidence of adenohypophyseal insufficiency present in this case. It is speculated that this lesion may be related to cell-mediated autoimmunity and other organ-specific autoimmune disorders.