Kini Hema, Rao Ranjitha, Pai Muralidhar
Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India.
Department of Neurosurgery, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India.
Indian J Pathol Microbiol. 2019 Jul-Sep;62(3):448-450. doi: 10.4103/IJPM.IJPM_319_18.
Hypophysitis is classified into primary and secondary. Xanthomatous hypophysitis is one of the rare types of primary hypophysitis. A 55-year-old female presented with headache, vomiting, and blurring of vision. She also had endocrine dysfunction in the form of low serum T3, T4, and low cortisol levels. MRI scan showed a sellar expansile lesion suggestive of pituitary macroadenoma. Microscopy showed pituitary tissue replaced by inflammatory infiltrate made up of foamy histiocytes arranged in sheets along with lymphoplasmacytic infiltrate. Interspersed areas of fibrosis, hyalinization, few congested and sclerosed blood vessels were seen. Compressed residual pituitary tissue was identified at the periphery. Xanthomatous hypophysitis is a rare entity which can mimic as pituitary adenoma both clinically and radiologically. Accurate diagnosis at an early stage with postsurgical steroid therapy may help to prevent permanent pituitary damage.
垂体炎分为原发性和继发性。黄色瘤性垂体炎是原发性垂体炎中罕见的类型之一。一名55岁女性出现头痛、呕吐和视力模糊。她还存在内分泌功能障碍，表现为血清T3、T4水平降低以及皮质醇水平降低。MRI扫描显示鞍区有一个膨胀性病变，提示垂体大腺瘤。显微镜检查显示垂体组织被炎性浸润取代，炎性浸润由成片排列的泡沫状组织细胞以及淋巴细胞和浆细胞浸润组成。可见散在的纤维化、玻璃样变区域，有少量充血和硬化的血管。在周边发现了受压的残留垂体组织。黄色瘤性垂体炎是一种罕见的疾病，在临床和放射学上都可能被误诊为垂体腺瘤。早期准确诊断并术后使用类固醇治疗可能有助于预防永久性垂体损伤。
