Spectrum of Different Types of Hypophysitis: A Clinicopathologic Study of Hypophysitis in 31 Cases

Abstract

Hypophysitis has been histologically classified into five types: lymphocytic hypophysitis (LYH), granulomatous hypophysitis (GRH), xanthogranulomatous hypophysitis (XGH), xanthomatous hypophysitis (XH), and necrotizing hypophysitis. The present study evaluated 31 cases of hypophysitis to clarify their characteristic clinicopathologic features. The lesions were histologically classified into four groups: LYH (22 cases) including lymphocytic adenohypophysitis (LAH) (19 cases) and lymphocytic infundibuloneurohypophysitis (LINH) (3 cases), GRH (5 cases), XGH (2 cases), and XH (2 cases). In each group, the pituitary gland showed lymphocytic infiltration associated with focal or diffuse hypophysial destruction of variable severity and fibrosis. Histologic and clinical overlap among different types of hypophysitis, especially between LAH and LINH, suggest that these entities may have similar etiologic background and/or represent different stages of the same lesion. Considering the sampling sites and clinical manifestations, LAH may not usually involve the neurohypophysis, but LINH may often extend to the adenohypophysitis. A selective loss of adrenocorticotropic hormone-positive cells was seen in two patients with LAH despite only very slight lymphoplasmacytic infiltration. This suggests that there may be at least two causative mechanisms for hypopituitarism in hypophysitis: nonspecific destruction of all types of adenohypophysial cells by severe inflammation and selective destruction of specific adenohypophysial cells.

Xanthogranulomatous hypophysitis due to craniopharyngioma rupture: a case report

“…The final histological diagnosis was a xanthogranulomatous hypophysitis. [4] , those les acterized by pit unction [3] . In zed by an infiltr inically and rad and can occur i o a preexisting e mmunostaining nuloma [1][2][3][4] .…”

“…d to loss of [3] . XH is utoimmune generative highlighted iagnosis of r systemic s, the giant eated giant Plasma cell granuloma is one of the subtypes of inflammatory pseudotumor, is non-neoplastic proliferation of plasma cells.…”

“…Tashiro T et al [3] , described the histologically finding of PH and divided into the five categories: lymphocytic (LH), granulomatous (GH), xanthomatous (XH), necrotizing (NH) and xanthogranulomatous hypophysitis (XGH), with the latter being a mixture of the xanthomatous and granulomatous subtypes. They are also classified as either adenohypophysitis (AH) or infundibulo neurohypophysitis based on their structural location and areas of infiltration [3] , connecting of multinucleated giant cells, epithelioid cells and lymphocytic infiltration, in totaling, and cholesterol clefts have been reported within these tissue samples [3] .…”

“…They are also classified as either adenohypophysitis (AH) or infundibulo neurohypophysitis based on their structural location and areas of infiltration [3] , connecting of multinucleated giant cells, epithelioid cells and lymphocytic infiltration, in totaling, and cholesterol clefts have been reported within these tissue samples [3] .…”

A Progressive Case of Lymphocytic Hypophysitis Accompanied by Paresis of the Left Abducens Nerve

“…The etiologies of lymphocytic adenohypophysitis and infundibuloneurohypophysitis are considered to be related to a similar autoimmune pathogenesis based on histological and clinical overlap (3). Lymphocytic adenohypophysitis occurs mainly in women and most commonly presents in the later stages of pregnancy, resulting in hypopituitarism (4,5).…”