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[一例与肺和眼结节病相关的淋巴细胞性垂体炎]

[A case of lymphocytic adenohypophysitis associated with sarcoidosis of the lung and eye].

作者信息

Tokunaga T, Shigemori M, Katayama M, Kuramoto S, Hayashi H, Yamada K, Nonaka K, Sasaguri Y

机构信息

Department of Neurosurgery, Kurume University School of Medicine.

出版信息

No Shinkei Geka. 1990 Feb;18(2):183-8.

PMID:2186292
Abstract

Lymphocytic adenohypophysitis is considered to be an inflammatory disease of the adenohypophysis that is commonly present with visual disturbance and hypopituitarism. Its etiology remains unclear but it is often related to an autoimmune disorder involving other organs, such as the thyroid, parathyroid, or adrenal glands. We encountered a rare case of lymphocytic adenohypophysitis associated with sarcoidosis of the lung and eye during the follow-up period. A 23-year-old woman was hospitalized in July 1986, with a one-month history of headache and visual disturbances which began three days after her second normal delivery. On admission, she showed slight visual impairment and had a left temporal superior quadrantanopia. Endocrinological evaluation revealed thyroid and adrenal hypofunction, and low response of human growth hormone to the loading test. A skull X-ray showed normal shaped sella with some erosion of the dorsum. CT scan showed a rounded contrast-enhanced intrasellar mass extending into the suprasellar cistern. MRI (SR: 500/30) showed a homogeneous low intensity mass which contained a small high intensity area on the relative T2-weighted image (2000/50). A biopsy was performed via right frontotemporal craniotomy. The consistency of the resected tissue was firmer than that of pituitary adenoma. Histologically, the tissue showed diffuse lymphocytic infiltration with some normal adenohypophysis. Her postoperative course was uneventful and the visual impairment improved two months later after the operation. Six months after the operation, she was readmitted with complaints of general fatigue and breathlessness. Chest X-ray showed diffuse infiltration throughout both lung fields, but there was no bilateral hilar lymphadenopathy.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

淋巴细胞性垂体炎被认为是一种垂体前叶的炎症性疾病,通常表现为视力障碍和垂体功能减退。其病因尚不清楚,但常与涉及其他器官(如甲状腺、甲状旁腺或肾上腺)的自身免疫性疾病有关。在随访期间,我们遇到了一例罕见的淋巴细胞性垂体炎,伴有肺部和眼部结节病。一名23岁女性于1986年7月住院,有1个月头痛和视力障碍病史,始于第二次正常分娩后3天。入院时,她有轻微视力损害,左侧颞上象限偏盲。内分泌评估显示甲状腺和肾上腺功能减退,人生长激素对负荷试验反应低下。头颅X线显示蝶鞍形态正常,鞍背有一些侵蚀。CT扫描显示鞍内圆形强化肿块延伸至鞍上池。MRI(自旋回波:500/30)显示在相对T2加权像(2000/50)上有一个均匀低信号肿块,其中包含一个小的高信号区。通过右额颞开颅进行活检。切除组织的质地比垂体腺瘤更硬。组织学上,组织显示弥漫性淋巴细胞浸润,伴有一些正常垂体前叶组织。她术后恢复顺利,术后2个月视力损害有所改善。术后6个月,她因全身乏力和呼吸困难再次入院。胸部X线显示双肺野弥漫性浸润,但无双侧肺门淋巴结肿大。(摘要截短于250字)

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