Lymphocytic hypophysitis

Lymphocytic hypophysitis (LH) is a rare but increasingly recognized inflammatory disorder of the pituitary, usually associated with pregnancy. Knowledge of this condition is largely anecdotal; the cause, incidence, and natural history are unknown. Cases are usually discovered at biopsy and surgical intervention for a presumptive pituitary neoplasm. Here we describe two cases of lymphocytic hypophysitis. In the first case the patient underwent surgery for presumptive adenoma, and pathology at resection established the diagnosis of lymphocytic hypophysitis. The second case was strongly suspicious for LH by history, endocrine profile, and imaging, and was managed nonoperatively. Though magnetic resonance imaging (MRI) features are not diagnostic, knowledge of imaging features together with clinical history may permit avoidance of surgery.