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Lymphocytic hypophysitis: occurrence in two men
J H Lee1, E R Laws, B L Guthrie
1Department of Pathology, George Washington University Medical Center, Washington, District of Columbia.
Neurosurgery
|January 1, 1994
Summary
Two men diagnosed with lymphocytic hypophysitis, a rare pituitary inflammation, required surgery. This condition mimics pituitary adenoma but necessitates histological diagnosis and long-term hormone replacement therapy.
Area of Science:
- Endocrinology
- Neurosurgery
- Pathology
Background:
- Lymphocytic hypophysitis is a rare inflammatory condition affecting the pituitary gland.
- It can present with symptoms mimicking pituitary adenoma, leading to diagnostic challenges.
Observation:
- Two male patients presented with headaches, lethargy, and low testosterone, suggestive of pituitary dysfunction.
- Magnetic resonance imaging revealed pituitary enlargement and optic chiasm involvement, with intraoperative dural adhesion to the pituitary.
Findings:
- Histopathological examination of resected pituitary glands showed lymphoplasmacytic infiltrate and fibrosis, confirming lymphocytic hypophysitis.
- Imaging findings, including nonspecific peripheral enhancement, can be misleading, necessitating a high index of suspicion.
Implications:
- Accurate diagnosis of lymphocytic hypophysitis requires histological confirmation, often necessitating surgical intervention.
- Patients typically require long-term pituitary hormone replacement therapy due to gland damage.