Tanimoto Keiji, Imbe Ayumi, Shishikura Kanako, Imbe Hisashi, Hiraiwa Tetsuya, Miyata Tomo, Ikeda Naokado, Kuroiwa Toshihiko, Terasaki Jungo, Hanafusa Toshiaki
Department of Internal Medicine (I), Osaka Medical College, Japan.
Intern Med. 2015;54(10):1247-51. doi: 10.2169/internalmedicine.54.3435. Epub 2015 May 15.
A 50-year-old woman presented with a headache and nausea. A sellar and suprasellar mass was detected on MRI; the tumor was heterogeneously enhanced with gadolinium, and the pituitary stalk was slightly thickened. Laboratory tests revealed severe growth hormone, luteinizing hormone, follicle-stimulating hormone and thyroid-stimulating hormone deficiencies. A pathological examination of the tumor showed scattered granulomas with central necrosis and Langhans giant cells. Tuberculin skin and QuantiFERON TB-Gold tests (QFT-2G) were positive. Accordingly, we diagnosed the patient with pituitary tuberculoma presenting with pituitary dysfunction. Following treatment with antituberculous drugs, the pituitary hormone function normalized and the pituitary tuberculoma disappeared.
一名50岁女性出现头痛和恶心症状。MRI检查发现鞍区和鞍上有肿块;肿瘤在钆增强扫描中呈不均匀强化,垂体柄略有增粗。实验室检查显示生长激素、黄体生成素、卵泡刺激素和促甲状腺激素严重缺乏。肿瘤病理检查显示散在的肉芽肿,伴有中央坏死和朗汉斯巨细胞。结核菌素皮肤试验和结核感染T细胞检测(QFT-2G)均为阳性。因此,我们诊断该患者为垂体结核瘤伴垂体功能障碍。经抗结核药物治疗后,垂体激素功能恢复正常,垂体结核瘤消失。