Unusual MRI findings in lymphocytic hypophysitis with central diabetes insipidus

Abstract

We report an unusual case of lymphocytic hypophysitis, which proved to be cystic at surgery.

Parasellar T2 Dark Sign on MR Imaging in Patients with Lymphocytic Hypophysitis

“…25 Cystic appearance was described in 5% of the patients with LYH. 1,8,11,12,[26][27][28][29][30][31][32][33][34] Homogeneous enhancement can also be observed in pituitary adenomas. 35 On the other hand, parasellar T2 dark sign was a characteristic finding in LYH and can contribute to distinguishing pituitary LYH from adenoma with certainty.…”

A Case of Cystic Lymphocytic Hypophysitis with Cacosmia and Hypopituitarism

“…Since Farah et al first reported cystic lymphocytic hypophysitis, only 5 cases of cystic lymphocytic hypophysitis and 2 cases of cystic granulomatous hypophysitis have been described, while Puchner et al reported 3 cases of lymphocytic hypophysitis with cystic craniopharyngioma [7][8][9]26]. Although the evidence of Rathke's cleft cyst or craniopharyngioma such as columnar epithelial layers or squamous metaplasia was not found in our case, the possibility remains that the histological findings of this patient's pituitary tissue may be the secondary changes caused by some other cystic diseases.…”

“…The diagnosis of this entity should be made by histological findings characteristic of massive infiltration of lymphocytes and plasma cells followed by necrosis or surrounding parenchymal fibrosis [5,6]. Previously reported cases of lymphocytic hypophysitis have nonspecific, solid enlargement of the pituitary gland but only 5 cases of cystic lymphocytic hypophysitis have been described in English literature [7][8][9].…”

Reversible impairment of the processing of proopiomelanocortin into ACTH in pituitary enlargement suspected of lymphocytic hypophysitis

“…The most unique and prominent MRI features are the pituitary stalk thickening and marked enlargement of the pituitary gland with homogeneous contrast enhancement. In some cases, lymphocytic hypophysitis has been reported to show a cystic appearance [15,16]. Thus, there are many variations of MRI features of lymphocytic hypophysitis.…”