Lymphocytic hypophysitis: Light and electron microscopic findings and correlation to clinical appearance
- 40 Downloads
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.
Key WordsLymphocytic hypophysitis pituitary tumor morphology immunocytochemistry electron microscopy
Unable to display preview. Download preview PDF.
- 1.Lloyd RV. Surgical pathology of the pituitary gland. Philadelphia: Saunders, 1993.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
- 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.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
- 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.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.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
- 21.Saeger W, Sautner D, Puchner MJA, Lüdecke DK. Hypophysitis in post-morten and surgical pituitaries. Endocr Pathol 6:380–381, 1995.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