Pituitary macroadenoma with persisting dense lymphocytic infiltration in a young male patient.
Clinical neuropathology, cilt.30, sa.6, ss.318-23, 2011 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 30 Sayı: 6
- Basım Tarihi: 2011
- Doi Numarası: 10.5414/np300378
- Dergi Adı: Clinical neuropathology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.318-23
- Anahtar Kelimeler: pituitary adenoma, hypophysitis, transsphenoidal surgery, prolactin, HYPOPHYSITIS, ANTIBODIES, ADENOMA
- İstanbul Üniversitesi Adresli: Evet
Özet
Context: Lymphocytic anterior hypophysitis in association with a pituitary adenoma was reported previously. In rare instance, inflammatory infiltration was confined to adenoma tissue itself, excluding anterior pituitary. Case: The patient a 27-year-old male presented with visual field defect. Further examination revealed a pituitary mass with suprasellar extension. Hormonal evaluation indicated mild hyperprolactinemia (42 ng/ml, normal < 19). After transsphenoidal resection, a pituitary adenoma showing cytoplasmic immunoreactivity to prolactin was identified. Dense and diffuse lymphocytic infiltration was seen within the tumor. At 15th month, a second transsphenoidal operation was necessary because of rapid development of visual compromise and headache. Excised surgical specimen consistent with previously resected adenoma showed diffuse lymphocytic infiltration composed of B and T cells within the adenoma tissue again. Conclusion: Presence of dense, hypophysitis-like lymphocytic infiltration within pituitary adenoma tissue obtained by two consecutive operations may reflect an host-mediated immune reaction to tumor. This rare finding could be challenging in terms of differential diagnosis and follow-up course.