Mikami T, Uozumi T, Yamanaka M, Sakoda K, Kanazawa J, Kagawa Y, Kajima T
Department of Neurosurgery, Hiroshima University School of Medicine.
No Shinkei Geka. 1989 Sep;17(9):871-6.
We report a case of a 26-year-old woman who had developed decrease of visual acuity, and restriction of the temporal visual field of the left eye in the 30th week of gestation. A skull roentgenogram showed no abnormality, but a pituitary mass was visualized by plain computed tomographic scan. Magnetic resonance imaging (MRI) demonstrated a symmetric sellar mass which had homogeneous signal intensity in all pulse sequences. T1 relaxation time of the mass was elongated as compared with that of a normal pituitary gland. The height of the mass was 11mm, and optic chiasm appeared compressed by the mass. Her visual disturbance improved before delivery, and the size of the pituitary mass regressed spontaneously. Although no histological examination was carried out, the most likely explanation for this phenomenon is lymphocytic adenohypophysitis. Early surgical intervention is not required for lymphocytic adenohypophysitis, because this disorder may be self-limiting, and may resolve itself. Most of these cases have been reported in women, often coincident with pregnancy. So we consider that MRI is the most useful and safest method for diagnosis and follow-up of this disease.
我们报告一例26岁女性病例，该患者在妊娠第30周时出现视力下降及左眼颞侧视野受限。颅骨X线片未见异常，但普通计算机断层扫描显示垂体有肿物。磁共振成像（MRI）显示一个对称的鞍区肿物，在所有脉冲序列中信号强度均匀。与正常垂体相比，肿物的T1弛豫时间延长。肿物高度为11mm，视交叉似乎被肿物压迫。她的视觉障碍在分娩前有所改善，垂体肿物大小自发缩小。尽管未进行组织学检查，但对此现象最可能的解释是淋巴细胞性垂体炎。淋巴细胞性垂体炎不需要早期手术干预，因为这种疾病可能是自限性的，可自行缓解。这些病例大多报道于女性，常与妊娠相关。因此，我们认为MRI是诊断和随访该疾病最有用和最安全的方法。
