Radiology, Vol 195, 30-34, Copyright © 1995 by Radiological Society of North America
Lymphocytic adenohypophysitis: contrast-enhanced MR imaging in five cases
J Ahmadi, GS Meyers, HD Segall, OP Sharma and DR Hinton
Department of Radiology, Los Angeles County-University of Southern California Medical Center 90033.
PURPOSE: To describe observations of adenohypophysitis on magnetic
resonance (MR) images. MATERIALS AND METHODS: Clinical, enhanced MR
imaging, surgical, and histologic findings were retrospectively studied in
four female patients and one male patient with adenohypophysitis who
presented with headaches, pituitary insufficiency, or hyperprolactinemia.
Results were compared with MR imaging, surgical, and pathologic findings in
128 consecutive cases of newly diagnosed pituitary adenomas. RESULTS: In
two of the four female patients, disease onset was not associated with a
recent history of pregnancy. Imaging findings included a slightly
lobulated, intensely enhancing pituitary mass (n = 5); enhancement along
the infundibulum (n = 4); and adjacent dural enhancement (n = 4). Four
patients had extrapituitary involvement. Some of these findings were noted
in patients with pituitary adenomas complicated by infarction, hemorrhage,
or necrosis. CONCLUSION: The observed clinical and MR imaging findings are
suggestive of adenohypophysitis; the latter, however, are not specific and
may be seen in some complicated cases of pituitary adenoma and other rare
forms of pituitary inflammation. Biopsy may be needed to establish the
correct diagnosis if a trial of steroid therapy fails.
