Primary pituitary tuberculosis

Kumar, Tarun; Nigam, Jitendra Singh; Jamal, Iffat; Jha, Vikas Chandra

doi:10.4322/acr.2020.228

Cited by 12 publications

(15 citation statements)

References 51 publications

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“…The incidence of tubercular hypophysitis is 0.5-4% of all intracranial lesions and 25-30% of tubercular hypophysitis cases reported in literature had previous or active tuberculosis ( 98 ). Primary pituitary tuberculosis caused by Mycobacterium tuberculosis, is a sporadic condition, and only 106 cases were reported from 1924 till 2019 ( 99 ). Tuberculosis usually occurs in endemic countries and it is rare in children.…”

Section: Discussionmentioning

confidence: 99%

Pituitary Stalk Thickening: Causes and Consequences. The Children’s Memorial Health Institute Experience and Literature Review

et al. 2022

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BackgroundPituitary stalk thickening (PST) is a rare abnormality in the pediatric population. Its etiology is heterogeneous. The aim of the study was to identify important clinical, radiological and endocrinological manifestations of patients with PST and follow the course of the disease.Materials and MethodsIt is a study conducted in 23 patients (13 boys) with PST with/without central diabetes insipidus (CDI) diagnosed between 1990 and 2020 at Children’s Memorial Health Institute (CMHI) in Warsaw, Poland. We analyzed demographic data, clinical signs and symptoms, radiological findings, tumor markers, hormonal results, treatment protocols and outcomes.ResultsThe median age at the diagnosis of PST was 9.68 years (IQR: 7.21-12.33). The median time from the onset of the symptoms to the diagnosis was 2.17 years (IQR: 1.12-3.54). The most common initially reported manifestations were polydipsia, polyuria and nocturia (82.6%); most of the patients (56.5%) also presented decreased growth velocity. Hormonal evaluation at the onset of PST revealed: CDI (91.3%), growth hormone deficiency (GHD) (56.5%), hyperprolactinemia (39%), central hypothyroidism (34.8%), adrenal insufficiency (9%), precocious puberty (8.7%). The majority of the patients were diagnosed with germinoma (seventeen patients – 73.9%, one of them with teratoma and germinoma). Langerhans cell histiocytosis (LCH) was identified in three patients (multisystem LCH in two patients, and unifocal LCH in one patient). A single case of atypical teratoid rhabdoid tumor, suspected low-grade glioma (LGG) and lymphocytic infundibuloneurohypophysitis (LINH). The overall survival rate during the observational period was 87.0%.ConclusionsThe pituitary infundibulum presents a diagnostic imaging challenge because of its small size and protean spectrum of disease processes. Germinoma should be suspected in all children with PST, especially with CDI, even when neurological and ophthalmological symptoms are absent.

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Section: Discussionmentioning

confidence: 99%

Pituitary Stalk Thickening: Causes and Consequences. The Children’s Memorial Health Institute Experience and Literature Review

et al. 2022

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“…Tuberculosis of central nervous system(CNS) represents 0.15-4% of all intracranial space occupying lesions. [1][2][3][4][5] The frequently affected sites are cerebrum, cerebellum, brain stem, perimeningeal spaces. 6,7 Involvement of pituitary is extremely rare even in endemic areas.…”

Section: Introductionmentioning

confidence: 99%

Sellar Tuberculosis Mimicking Pituitary Adenoma

Maharjan

Satyal

Baidya

2022

Kathmandu Univ. Med. J.

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Tuberculosis of central nervous system accounts for only 1% of tuberculosis cases worldwide, of which pituitary is an extremely unusual site. We report a case of pituitary tuberculosis in a 29-year-old female presenting with complains of headache and diminished vision on right eye. It was misdiagnosed as pituitary adenoma on radiology. Biopsy showed epithelioid granulomas, langhans giant cells and caseous necrosis. Ziehl nelseen stain showed presence of acid fast bacilli confirming the tubercular etiology. Therefore, histology remains the mainstay for diagnosis of these lesions. Early diagnosis and prompt use of antitubercular drugs results in good outcome.

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“…[ 6 ] In the absence of pulmonary TB or other organ involvement, the primary pituitary TB is a very uncommon disease. [ 7 ] Incidence and prevalence of primary pituitary tuberculosis is not known. Only few case reports can be found after a thorough literature review.…”

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confidence: 99%

“…The age ranged from 5 to 69 years with female: male ratio being 2.55:1. [ 7 ] Pituitary adenomas comprises the common aetiology in the sellar region, but unusual nonadenohypophyseal lesions and inflammatory pathologies must be considered in the differential diagnosis of a sellar mass. [ 8 ] Pathogenesis of TB bacilli spreading to the pituitary gland without apparent involvement of other body organs remains unclear.…”

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confidence: 99%