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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.

|January 1, 1994

Summary

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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.

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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.