Lymphocytic Hypophysitis with Involvement of the Cavernous Sinus and Hypothalamus

Nussbaum, Charles E.; Shige-Hisa, Okawara; Jacobs, Laurence S.

doi:10.1227/00006123-199103000-00019

Cited by 84 publications

(25 citation statements)

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“…41 Therefore, the parasellar T2 dark sign is more suitable for LYH that infiltrates around the pituitary. Some previous studies have reported cavernous involvement in patients with LYH, 5,6,10,[42][43][44][45][46] but no studies have mentioned the parasellar T2 dark sign.…”

Section: Discussionmentioning

confidence: 96%

“…The treatment of LYH remains controversial, though conservative management with close clinical observation has been advocated on the basis of its often benign transient course. 9,10 The correct diagnosis of LYH contributes to avoiding needless surgery, which is invasive and sometimes results in endocrine dysfunction. However, distinguishing LYH from pituitary adenomas can be difficult.…”

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confidence: 99%

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Parasellar T2 Dark Sign on MR Imaging in Patients with Lymphocytic Hypophysitis

Nakata¹,

Sato²,

Masumoto³

et al. 2010

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 96%

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confidence: 99%

Parasellar T2 Dark Sign on MR Imaging in Patients with Lymphocytic Hypophysitis

Nakata¹,

Sato²,

Masumoto³

et al. 2010

AJNR Am J Neuroradiol

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“…Chronic inflammation in the sella turcica is classified according to the gland of main involvement. Lymphocytic infiltration confined mainly to the anterior pituitary is termed lymphocytic adenohypophysitis [5,7,[17][18][19], and that confined mainly to the neurohypophysis and inf undibulum is termed infundibuloneurohypophysitis [8]. These hypophyseal inflammatory diseases have been considered to be autoimmune with a self-limiting course [20][21][22][23][24], but some of these diseases have also been found to have associated lesions of adjacent structures [17-19, 25, 26].…”

Section: Discussionmentioning

confidence: 99%

Parasellar Chronic Inflammatory Disease Presenting Tolosa-Hunt Syndrome, Hypopituitarism and Diabetes Insipidus: A Case Report.

et al. 1996

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Abstract.We In June, 1988, a 60-year-old Japanese man, who had been under treatment for hypertension for the last 15 years, began to have intermittent, painful left ophthalmoplegia.He was admitted to a local hospital, where he was treated with steroids, which provided some relief, and he was discharged. Two years later, he also noted decreasing visual acuity in his left eye, and he consulted the Department of Neurosurgery, Hiroshima University School of Medicine.Magnetic resonance (MR) imaging demonstrating enlargement of the left cavernous sinus and occlusion of the left internal carotid artery. He was again started on a regimen of 3 mg of betamethasone per day, which provided some relief, but the symptoms recurred when the steroid treat-

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“…Surgery should be performed in cases with progressive compression or those in whom radiological and/or clinical progression occurs during conservative medical management (7). The hyperprolactinemia and mass effect such as visual disruption and stalk compression (DI) resolves after surgery in most cases (23,27,29). On the other hand, definitive histological diagnosis of hypophysitis may obviate the unnecessary use of high-dose steroid therapy and facilitate the treatment of other conditions such as infection or neoplasm (21).…”

Section: Patientmentioning

confidence: 99%

Primary non-necrotizing granulomatous hypophysitis mimicking pituitary adenomas

Yıldırım¹,

Divanlıoğlu²,

Çetinalp³

et al. 2014

Turkish Neurosurgery

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AIm:The authors review their experience in the endoscopic endonasal transsphenoidal treatment of 5 patients, finally diagnosed as primary hypophysitis but initially assumed to be pituitary adenomas. mATERIAL and mETHods: A retrospective study was undertaken to review 5 cases of primary non-necrotizing granulomatous hypophysitis (1.61%) through 310 endoscopic transsphenoidally operated cases with the diagnosis of pituitary adenoma between 2009 and 2013. All 5 cases were female without any background of autoimmunity or recent pregnancy. The initial presumptive diagnosis was pituitary adenoma for all patients. The endocrinological diagnoses of the patients were suspected Cushing's Disease, anterior pituitary deficiency with hyponatremia, hyperprolactinemia, and acromegaly. One of the patients had normal hormonal levels. All patients had macroadenomas including one invasive adenoma with skull base involvement. One of the patients (20%) had visual field defects. All patients underwent endoscopic endonasal transsphenoidal surgery (EETS). REsuLTs:All patients had improvement of hormonal levels postoperatively except the one with anterior pituitary deficiency who required long term hormone replacement after the surgery. Mean follow-up duration was 14.8 months.CoNCLusIoN: Primary granulomatous hypophysitis without any known etiological factors is very rare in the literature. It can mimic pituitary adenomas in radiological and endocrinological aspects. EETS is an effective and safe treatment especially for visual and compression symptoms.KEywoRds: Primary hypophysitis, Non-necrotizing, Granulomatous, Endoscopic, Secretory adenoma ÖZ AmAÇ: Hipofiz adenomu ön tanısı ile endoskopik endonazal transsfenoidal (EETS) yöntemle tedavi edilen ve patoloji tanısı primer hipofizit olan 5 olguluk deneyim sunulmaktadır. yÖNTEm ve GEREÇLER: Çalışmada 2009 ile 2013 yılları arasında endoskopik endonazal yolla opere edilen 310 hipofiz adenomu olgusu içerisinden patoloji tanısı primer nonnekrotizan granulomatöz hipofizit olan 5 olgu (%1,61) geriye dönük olarak incelendi. Hastaların hepsi kadın cinsiyette olup, hiçbirinde gebelik ya da altta yatan otoimmün hastalık gibi bir neden yok idi. Tüm hastaların ön tanısı hipofiz adenomu idi. Hastalarda endokrinolojik olarak sırasıyla şüpheli Cushing Hastalığı, hiponatremi ile birlikte hipofizer yetmezlik, hiperprolaktinemi, normal hormonal tablo ve akromegali ile uyumlu laboratuvar değerleri saptandı. Bir tanesi kafa kaidesi tutulumu ile birlikte invaziv adenom olmak üzere tüm olgular makroadenomdu. Bir hastada görme alanı defisiti saptandı. Tüm hastalara EETS cerrahi uygulandı.BuLGuLAR: Preoperatif yetmezlik bulguları olan hasta hariç tüm hastalarda postoperatif normal hormonal değerler sağlandı.Hastalar ortalama 14,8 ay takip edildi.soNuÇ: Primer non-nekrotizan hipofizitler nedeni bilinmeyen ve nadir görülen hastalıklar olup radyolojik ve endokrinolojik olarak hipofiz adenomlarını taklit edebilirler. EETS yol ise görme ile ilgili ve bası semptomlarının kaldırılmasında güvenli ve etkili bir...

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Lymphocytic Hypophysitis with Involvement of the Cavernous Sinus and Hypothalamus

Cited by 84 publications

References 0 publications

Parasellar T2 Dark Sign on MR Imaging in Patients with Lymphocytic Hypophysitis

Parasellar T2 Dark Sign on MR Imaging in Patients with Lymphocytic Hypophysitis

Parasellar Chronic Inflammatory Disease Presenting Tolosa-Hunt Syndrome, Hypopituitarism and Diabetes Insipidus: A Case Report.

Primary non-necrotizing granulomatous hypophysitis mimicking pituitary adenomas

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