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Lymphocytic hypophysitis: Light and electron microscopic findings and correlation to clinical appearance

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Abstract

Light and electron microscopic findings of six cases of lymphocytic hypophysitis of a collective of 2500 surgical specimens are presented. Five cases were obtained by surgery, one case was obtained from autopsy. Light microscopy revealed an infiltration of mature lymphocytes and plasma cells in the interstitium, partly in the acini, as well as in the posterior lobe and the capsule. The structure of the remaining anterior lobe was normal. The final stage of lymphocytic hypophysitis is fibrosis, which was seen in all cases to varying degrees. The infiltrate consisted mainly of T-lymphocytes, being positive for CK 45 RO and CD 43. Immunocytochemical staining revealed different proportions of residual adenohypophyseal cells. Mainly prolactin reactive cells were observed as were growth hormone reactive cells. By electron microscopy some ruptured acini and damaged adenohypophyseal cells could be seen. Few pituitary cells contained enlarged lysosomal bodies or oncocytic changes. Inflammation causing enlargement of the pituitary leads to patients often being operated under the preoperative diagnosis of a tumor of the sellar region. It is important to identify this special type of hypophysitis, as a different course of treatment is required.

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References

  1. Lloyd RV. Surgical pathology of the pituitary gland. Philadelphia: Saunders, 1993.

    Google Scholar 

  2. Groll A, Schneider M, Althoff PH, Falkenbach A, Helm EB, Keul HG, Scheiblinger S, Hübner K. Morphologie und klinische Bedeutung pathologischer Veränderungen an Nebennieren und Hypophyse bei AIDS. Dtsch med Wschr 115:483–488, 1990.

    Article  PubMed  CAS  Google Scholar 

  3. Püschel W, Wernert N, Hinkeldey KKM, Brittner-Flemmer V, Remberger K. Granulomatöse Hypophysitis. Bericht über drei Fälle und Literaturübersicht. Pathologe 13:100–103, 1992.

    PubMed  Google Scholar 

  4. Scheithauer BW. The hypothalamus and neurohypophysis. In: Kovacs K, Asa SI, eds. Functional endocrine pathology. Oxford, UK: Blackwell Scientific 1991; 170–245.

    Google Scholar 

  5. Scanarini M, d'Avella D, Rotilio A, Kitromilis N, Mingrino S. Giant-cell granulomatous hypophysitis: a distincr clinicopathological entity. J Neurosurg 71:681–686, 1989.

    Article  PubMed  CAS  Google Scholar 

  6. Yoshioka M, Yamakawa N, Saito H, Yoneda M, Nakayama T, Kuroki M, et al. Granulomatous hypophysitis with meningitis and hypopituitarism. Int Med 31:1147–1150, 1992.

    CAS  Google Scholar 

  7. Sautner D, Saeger W, Lüdecke DK, Jansen V, Puchner MJA. Hypophysitis in surgical and autoptical specimens. Acta Neuropath (Wien) 90:637–644, 1995.

    Article  CAS  Google Scholar 

  8. Saeger W, Sautner D, Puchner MJA, Lüdecke DK. The hypophysitis in surgical specimen. Exp Clin Endocrinol 103(Suppl 1):57, 1995.

    Google Scholar 

  9. Goudie RB, Pinkerton PH. Anterior hypophysitis and Hashimoto's disease in a young woman. J Pathol Bacteriol 83:584,585, 1962.

    Article  PubMed  CAS  Google Scholar 

  10. Patel MC, Guneratne N, Haq N, West TET, Weetman AP, Clayton RN. Peripartum hypopituitarism and lymphocytic hypophysitis. Q J Med 88:571–580, 1995.

    CAS  Google Scholar 

  11. Feigenbaum SL, Martin MC, Wilson CB, Jaffe RB. Lymphocytic adenohypophysitis: A pituitary mass lesion occurring in pregnancy. Am J Obstet Gynecol 164:1549–1555, 1991.

    PubMed  CAS  Google Scholar 

  12. Morange I, Brue T, Blanc P, Costa R, Jaquet P. Post-partum anterior pituitary failure and autoimmune thyroiditis: Pituitary necrosis or hypophysitis? Presse Med 24:1133–1133, 1995.

    PubMed  CAS  Google Scholar 

  13. Lee J-H, Laws ER, Guthrie BL, Dina TS, Nochomovitz LE. Lymphocytic hypophysitis: occurrence in two men. Neurosurgery 34:159–163, 1994.

    Article  PubMed  CAS  Google Scholar 

  14. Abe T, Matsumoto K, Sanno N, Osamura Y. Lymphocytic hypophysitis: case report. Neurosurgery 36:1016–1019, 1995.

    Article  PubMed  CAS  Google Scholar 

  15. Riedl M, Czech T, Slootweg J, Czernin S, Hainfellner JA, Schima W, Vierhappner H, Luger A. Lymphocytic hypophysitis presenting as a pituitary tumor in a 63-year-old-man. Endocr Pathol 6:159–166, 1995.

    PubMed  Google Scholar 

  16. Garcin JM, Pharaboz C, Laborde JP, Ceccaldi B, Clement R, Bauduceau B. Premenopausal hyperprolactinemia revealing pseudo-tumoural hypophysitis. Press Med. 24:1134–1134, 1995.

    CAS  Google Scholar 

  17. von Werder K. Pituitary enlargement. Clin Endocrinol 44:299–303, 1996.

    Article  Google Scholar 

  18. Sautner D, Saeger W, Lüdecke D.K., Puchner MJA. Die Hypophysitis als Raumforderung der Sellaregion im Operationsmaterial. Verh Dtsch Ges Path 75:511–511, 1991.

    Google Scholar 

  19. Thodou E, Asa SL, Kontogeorgos G, Kovacs K, Horvath E, Ezzat S. Clinical case seminar: lymphocytic hypophysitis: clinicopathological findings. J Clin Endocrinol Metab 80:2302–2311, 1995.

    Article  PubMed  CAS  Google Scholar 

  20. Saeger W, Moser R, Wernert N. Entzündliche (?) Infiltrate der Hypophyse. Untersuchungen an einem großen Sektionskollektiv. Pathologe 8:261–267, 1987.

    PubMed  CAS  Google Scholar 

  21. Saeger W, Sautner D, Puchner MJA, Lüdecke DK. Hypophysitis in post-morten and surgical pituitaries. Endocr Pathol 6:380–381, 1995.

    Google Scholar 

  22. Nishioka H, Iro H, Miki T, Wada J, Sano T. Lymphocytic adenohypophysitis associated with Rathke's cleft cyst. Endocr Pathol 6:337–343, 1995.

    PubMed  Google Scholar 

  23. Puchner MJA, Lüdecke DK, Saeger W. The anterior pituitary lobe in patients with cystic craniopharyngiomas: three cases of associated lymphocytic hypophysitis. Acta neurochir. (Wien) 126:38–43, 1994.

    Article  CAS  Google Scholar 

  24. Puchner MJA, Lüdecke DK, Schmiegel WH, Saeger W, Herrmann H-D. Different types of hypophysitis. J Endocr Invest 14(Suppl 1): 79, 1991.

    Google Scholar 

  25. Puchner MJA, Lüdecke DK, Lohmann F, Saeger W. The anterior pituitary lobe in patients with cystic craniopharyngiomas: high incidence of associated lymphocytic hypophysitis. J Endocr Invest 16(Suppl 1–8):131 (A25)-131, 1993.

    Google Scholar 

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Authors and Affiliations

  1. Institute of Pathology of the Marienkrankenhaus, Alfredstraße 9, D-22087, Hamburg, Germany

    Marita Fehn MD & Wolfgang Saeger MD

  2. Clinic of Neurosurgery, University Hospital Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany

    Dieter K. Lüdecke MD

  3. Clinic Benjamin Franklin, Free University of Berlin, Department of Endocrinology, Hindenburgdamm 30, D-12203, Berlin, Germany

    Ursula Plöckinger MD

  4. Institute of Neuropathology, University of Heidelberg, Im Neuenheimer Feld 220, D-69120, Heidelberg, Germany

    Clemens Sommer MD

Authors
  1. Marita Fehn MD
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  2. Clemens Sommer MD
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  3. Dieter K. Lüdecke MD
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  4. Ursula Plöckinger MD
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  5. Wolfgang Saeger MD
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Fehn, M., Sommer, C., Lüdecke, D.K. et al. Lymphocytic hypophysitis: Light and electron microscopic findings and correlation to clinical appearance. Endocr Pathol 9, 71–78 (1998). https://doi.org/10.1007/BF02739954

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