Lymphocytic Hypophysitis

The Pituitary Mass: Diagnosis and Management

“…Diabetes insipidus has been reported in one third of patients with lymphocytic hypophysitis [9]. MRI imaging may show an enhancing pituitary mass in as many as 95% of cases, often with suprasellar extension [8,9]. There may also be loss of the posterior pituitary bright spot, thickening of the pituitary stalk and in some cases extension of the lesion to the hypothalamus [23,24].…”

“…Lymphocytic hypophysitis has an inexplicable unique predilection for the corticotrophs and thyrotrophs while sparing the gonadotrophs [9]. Diabetes insipidus has been reported in one third of patients with lymphocytic hypophysitis [9]. MRI imaging may show an enhancing pituitary mass in as many as 95% of cases, often with suprasellar extension [8,9].…”

“…Metastatic lesions to the pituitary gland usually appear as part of a widely metastatic carcinoma but rarely they may be the initial presentation of a carcinoma [1,7]. Lymphocytic hypophysitis primarily occurs in the last trimester of pregnancy or postpartum so should be a strong consideration in a woman who presents with a sellar mass at the end of her pregnancy or postpartum [8,9]. Pituitary abscess is more common in the immunocompromised, in individuals with concurrent pituitary lesions or prior pituitary surgery or irradiation [10].…”

“…Symptoms resulting from partial or panhypopituitarism occur in approximately 80% of cases [8,9]. Lymphocytic hypophysitis has an inexplicable unique predilection for the corticotrophs and thyrotrophs while sparing the gonadotrophs [9]. Diabetes insipidus has been reported in one third of patients with lymphocytic hypophysitis [9].…”

“…The true incidence of lymphocytic hypophysitis is unknown, but it is likely to be underestimated due to confusion with Sheehan's syndrome and due to the spontaneous recovery of undiagnosed cases. Symptoms resulting from partial or panhypopituitarism occur in approximately 80% of cases [8,9]. Lymphocytic hypophysitis has an inexplicable unique predilection for the corticotrophs and thyrotrophs while sparing the gonadotrophs [9].…”