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Tomographic abnormalities simulating pituitary microadenomas.

G Wortzman, N B Rewcastle

    AJNR. American Journal of Neuroradiology
    |September 1, 1982
    PubMed
    Summary
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    Sellar tomography can misinterpret pituitary microadenomas. Minor bony variations, often due to normal anatomy like posterior lobe asymmetry, can mimic abnormalities, necessitating cautious interpretation of sellar tomograms.

    Area of Science:

    • Radiology
    • Endocrinology
    • Anatomy

    Background:

    • Sellar tomography is used to detect pituitary microadenomas.
    • Abnormalities in sellar tomograms can lead to misinterpretations.

    Purpose of the Study:

    • To investigate the causes of false-positive and false-negative interpretations in sellar tomography for pituitary microadenomas.
    • To correlate bony variations of the sella with the presence of pituitary microadenomas.

    Main Methods:

    • Autopsy study correlating sellar tomograms with pituitary microadenomas.
    • Analysis of bony variations in 120 sellas.
    • In situ study of 50 pituitary glands to assess posterior lobe asymmetry.

    Main Results:

    Related Experiment Videos

  • Approximately one-fifth of sellar tomograms showed false-positive or false-negative results for pituitary microadenomas.
  • Minor bony variations (e.g., asymmetry, empty sella) were found in 27/120 sellas.
  • Posterior lobe asymmetry, a common anomaly (76%), significantly contributes to sellar asymmetry.
  • Conclusions:

    • Minor radiologic criteria for pituitary microadenoma must be interpreted cautiously.
    • Sellar asymmetry and other bony variations often result from explainable anatomic causes, not necessarily microadenomas.
    • Clinical and biochemical data are crucial for accurate diagnosis in the presence of ambiguous sellar tomograms.