Cheung C C, Ezzat S, Smyth H S, Asa S L
The Freeman Center for Endocrine Oncology, Mount Sinai Hospital, Department of Pathology, University of Toronto, Toronto, Ontario M5G 1X5, Canada.
J Clin Endocrinol Metab. 2001 Mar;86(3):1048-53. doi: 10.1210/jcem.86.3.7265.
Hypophysitis can present clinically as a mass lesion of the sella turcica. Secondary hypophysitis occurs in cases where a definite etiologic agent or process inciting the inflammatory reaction can be identified. In contrast, primary hypophysitis refers to inflammation confined to the pituitary gland with no identifiable etiologic associations. We report three cases of primary hypophysitis to illustrate the spectrum of three clinicopathological entities that encompass this disease: lymphocytic hypophysitis, granulomatous hypophysitis, and xanthomatous hypophysitis. Our three patients underwent surgery, with variable response. However, conservative, supportive treatment with or without surgical decompression is generally favored over aggressive and extensive surgical resection that results in hypopituitarism. We conclude that the optimal management of patients with hyophysitis requires a high index of suspicion before extensive surgical resection. Histological confirmation of the diagnosis of hypophysitis can be obtained by performing a biopsy or by requesting an intraoperative frozen section consultation.
垂体炎在临床上可表现为蝶鞍区的占位性病变。继发性垂体炎发生于能明确引起炎症反应的病因或过程的病例中。相比之下，原发性垂体炎是指局限于垂体的炎症，且无明确的病因关联。我们报告三例原发性垂体炎病例，以说明构成该疾病的三种临床病理实体的范围：淋巴细胞性垂体炎、肉芽肿性垂体炎和黄色瘤性垂体炎。我们的三名患者均接受了手术，反应各不相同。然而，一般而言，无论有无手术减压，保守、支持性治疗优于导致垂体功能减退的积极、广泛的手术切除。我们得出结论，垂体炎患者的最佳管理需要在进行广泛手术切除之前保持高度的怀疑。垂体炎的诊断可通过活检或术中冷冻切片会诊获得组织学证实。
