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Sellar Tuberculosis Mimicking Pituitary Adenoma
S Maharjan1, B Satyal1, R Baidya1
1Department of Pathology, B and B Hospital, Gwarko, Lalitpur, Nepal.
Kathmandu University Medical Journal (KUMJ)
|April 12, 2023
Summary
Pituitary tuberculosis is a rare condition, often misdiagnosed. Histology is key for diagnosing this central nervous system tuberculosis, leading to effective treatment with antitubercular drugs.
Area of Science:
- Neurology
- Infectious Diseases
- Endocrinology
Background:
- Central nervous system tuberculosis (CNS TB) is rare, comprising 1% of all TB cases.
- The pituitary gland is an exceptionally uncommon site for tuberculosis.
- Pituitary tuberculosis can be mistaken for pituitary adenoma on imaging studies.
Observation:
- A 29-year-old female presented with headache and diminished vision in the right eye.
- Radiological imaging suggested a pituitary adenoma.
- Histopathological examination revealed epithelioid granulomas, Langhans giant cells, and caseous necrosis.
Findings:
- Ziehl-Neelsen staining identified acid-fast bacilli, confirming tuberculous etiology.
- Histology is essential for diagnosing pituitary tuberculosis, differentiating it from other pituitary lesions.
- The case highlights the diagnostic challenges of pituitary tuberculosis.
Implications:
- Prompt antitubercular therapy is vital for favorable patient outcomes.
- This case underscores the importance of considering tuberculosis in the differential diagnosis of pituitary lesions, especially in endemic areas.
- Histopathological confirmation remains the gold standard for pituitary tuberculosis diagnosis.
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