Radiology Quiz 17094 | Radiopaedia.org

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Who typically is affected by lymphocytic hypophysitis?

Lymphocytic hypophysitis is seen most frequently in women (strong female predilection with a M : F of ~ 9 : 1), and often in the post-partum period or in the third trimester of pregnancy.

Question 2

When recognised preoperatively (usually in the setting of pregnancy) or after a biopsy confirms the diagnosis, what is the treatment?

Show Answer

Lymphocytic hypophysitis is usually self limiting and spontaneous recovery can occur. Corticosteroids are sometimes given and deficient hormones can be replaced.

The patient went on to have a transphenoidal resection.

Histology

MICROSCOPIC DESCRIPTION: Sections show small fragments of dense fibrous tissue with scattered clusters and distorted acini of functioning pituitary cells (GH and Prolactin positive). There is infiltration and destruction of pituitary acini by CD3, CD4 and CD8 positive T-cells. Small sheets of necrotic tissue are seen adjacent to the tissue. Occasional small clusters of histiocytes are identified but no clearly discernable granulomas are seen. No mycobacteria or fungi are identified on ZN and PAS stains. There is no evidence of malignancy.

DIAGNOSIS: Features favouring an autoimmune lymphocytic hypophysitis.