Lymphocytic Hypophysitis

Abe, Takumi; Matsumoto, Kiyoshi; Sanno, Naoko; Osamura, Yoshiyuki

doi:10.1097/00006123-199505000-00020

Cited by 22 publications

(37 citation statements)

References 13 publications

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“…Histologically, lymphocytic hypophysitis is characterized by diffusely inflammatory infiltration of the pituitary, predominant lymphocytes with occasional plasma cells and macrophages, and sometimes neutrophilic and eosinophilic polynuclear cells with a variable degree of fibrosis [4,9,27,[33][34][35][36]. Granulomatous hypophysitis is characterized by necrotizing granulomas that are formed by collection of histiocytes, multinucleated giant cell, and variable numbers of lymphocytes and plasma cells [4,9,18,26,27].…”

Section: Resultsmentioning

confidence: 99%

Primary granulomatous hypophysitis: a case report and literature review

Zhang

Yue

et al. 2011

Endocr J

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Section: Resultsmentioning

confidence: 99%

Primary granulomatous hypophysitis: a case report and literature review

Zhang

Yue

et al. 2011

Endocr J

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“…This is present in about 65% of cases (32); in rare cases it can induce acute secondary hyposurrenalism as the first appearance of the disease, with high mortality of affected patients (27,71). LYH can also cause thyrotropin (TSH) and/or gonadotropin deficiencies (which are usually misdiagnosed when LYH affects women in pregnancy or in the postpartum period) whereas data on the effects on growth hormone/insulin-like growth factor-I (GH/IGF-I) secretions are scarce and inconclusive (38).…”

Section: Clinics and Imaging Of Lyhmentioning

confidence: 97%

“…These were diagnosed on the basis of autoptical or post-hypophysectomy histopathological findings. Over the last 13 years the number of diagnosed cases has increased considerably, due probably to improved imaging criteria (31,32), and over 200 cases have been diagnosed by 2003, considering only those cases where the inflammatory process involved only the anterior lobe of the pituitary, without affecting the posterior lobe (2, 3, 13, 31 -64).…”

Section: Lymphocytic Hypophysitismentioning

confidence: 99%

Lymphocytic hypophysitis: a rare or underestimated disease?

Bellastella

Bizzarro²,

Coronella³

et al. 2003

Eur J Endocrinol

197

205

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Lymphocytic hypophysitis (LYH) is an uncommon autoimmune disease in which the pituitary gland is infiltrated by lymphocytes, plasma cells and macrophages and its function is usually impaired. It has to be suspected in pregnant women and in women with recent delivery presenting with hyperprolactinemia, headache, visual field alterations and changes of one or more pituitary hormone secretions with secondary impairment of related peripheral target glands, especially when associated with other autoimmune endocrine or non-endocrine disorders. It can also occur less frequently in prepubertal or post-menopausal women and in men. Headache, visual field impairment and more rarely diplopia are due to extrasellar pituitary enlargement with optic chiasma compression and/or to invasion of cavernous sinuses. Among the 'isolated' pituitary hormone deficiencies, ACTH deficit is usually the earliest and most frequent hormonal impairment and in rare cases can induce an acute secondary hyposurrenalism as the first sign of the disease, with high mortality in affected patients. Histopathological findings from pituitary biopsy show lymphoplasmacytic infiltrate with lymphoid aggregates surrounding atropic acini of pituitary cells; immunohistochemical analysis shows numerous mast cells randomly distributed and also localized in the vicinity of capillaries, suggesting a possible influence on capillary permeability and angiogenesis, thus favoring the inflammatory and immunological aggression against pituitary cells. Nuclear magnetic resonance imaging shows uniform sellar floor depression and an extrasellar symmetrical pituitary enlargement, usually displacing the optic chiasma, which shows a rapid homogeneous enhancement after gadolinium also involving the adjacent dura (dural tail). Antipituitary antibodies have been detected in several patients with LYH but their role needs to be clarified. Since a possible spontaneous remission can occur, a careful follow-up is required in subclinical patients without important hyposurrenalism or symptomatic extrasellar expansion. Medical (immunosuppressive, replacement and antiprolactinemic) and neurosurgical (decompression) treatments are needed in clinical symptomatic patients.

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“…1,[8][9][10] Granuloma formation may also occur in the pituitary gland and stalk, 6,8,10) frequently associated with tuberculosis, sarcoidosis, syphilis, and lymphocytic adenohypophysitis, and manifesting as systematic symptoms such as high fever and hormonal disturbances. 10) Recently, a case of granuloma in the pituitary stalk caused by nontuberculous mycobacteria (Mycobacterium malmoense) infection was reported.…”

Section: Introductionmentioning

confidence: 99%

Caseous Necrotic Granuloma in the Pituitary Stalk Due to Nontuberculous Mycobacteria (Mycobacterium Tokaiense) Infection-Case Report-

Kondo

Mori

Iwata³

et al. 2006

Neurol. Med. Chir.(Tokyo)

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A 36-year-old man with no history of immunosuppression presented with diabetes insipidus, but no other hormonal disturbances. Magnetic resonance imaging of the brain revealed an enhanced mass in the pituitary stalk appearing as a thickened pituitary stalk. The mass lesion was completely removed through the right optico-carotid space. Histological examination showed epithelioid cell granuloma with caseous necrosis, which strongly suggested mycobacterial infection. However, acid-fast staining detected no bacteria. Polymerase chain reaction (PCR) examinations of the gastric juice and cerebrospinal fluid for tuberculosis were negative. Nested PCR and deoxyribonucleic acid (DNA) sequencing of the DNA from the surgical specimen disclosed Mycobacterium tokaiense DNA sequences. This rare case of pituitary stalk granuloma caused by M. tokaiense shows that if the surgical specimen contains caseous necrosis, nested PCR and DNA sequencing are useful methods to identify mycobacterial infection.

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Lymphocytic Hypophysitis

Cited by 22 publications

References 13 publications

Primary granulomatous hypophysitis: a case report and literature review

Primary granulomatous hypophysitis: a case report and literature review

Lymphocytic hypophysitis: a rare or underestimated disease?

Caseous Necrotic Granuloma in the Pituitary Stalk Due to Nontuberculous Mycobacteria (Mycobacterium Tokaiense) Infection-Case Report-

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