How is lymphocytic hypophysitis diagnosed?

The definitive diagnosis of lymphocytic hypophysitis cannot be made without a tissue biopsy and confirmed pathology. Without a biopsy, in the presence of a pituitary mass, typical clinical presentation and hypopituitarism, there are numerous potential differential diagnoses (Box 4).

What causes lymphocytic hypophysitis?

The exact cause is unknown but is thought to be autoimmune-related. Although some cases resolve on their own or after a short course of steroids, other cases cause persistent problems even with aggressive medical or surgical treatment.

How is hypophysitis diagnosed?

A presumptive diagnosis of hypophysitis can be made in a patient with otherwise unexplained hypopituitarism with characteristic findings on pituitary MRI of diffuse pituitary gland enlargement and/or a thickened pituitary stalk (infundibulum).

What causes thickened pituitary stalk?

The common etiologies presenting with central diabetes insipidus (DI) associated with a thickened pituitary stalk in the pediatric population are: Langerhans Cell Histiocytosis (LCH), central nervous system tumors such as germinoma and craniopharyngioma, granulomatous lesions like tuberculosis and sarcoidosis and …

Which is the best MRI for lymphocytic hypophysitis?

MRI, as is the case with other pituitary lesions, is the best modality for assessing this condition which appears as a pituitary region mass. Lymphocytic hypophysitis is usually self-limiting and spontaneous recovery can occur. Corticosteroids are sometimes given and deficient hormones can be replaced 8.

What are the symptoms of lymphocytic hypophysitis ( PA )?

Lymphocytic Hypophysitis (LH) Pituitary Adenoma (PA) Presentation Headaches and visual changes more common infertlity more common Hormones Prolactin usually <100 pg/ml Prolactin usually >200pg/ml Radiology (MRI)

How does lymphocytic hypophysitis affect the optic chiasm?

Lymphocytic hypophysitis begins with acute inflammation of the pituitary marked by edema. This results in headaches and, if extensive, it can lead to compression of the optic chiasm. Endocrine changes may occur, ranging from undetectable to panhypopituitarism.

How is lymphocytic hypophysitis related to orbital pseudotumour?

Lymphocytic hypophysitis. Lymphocytic hypophysitis is an uncommon non-neoplastic inflammatory condition that affects the pituitary gland. It is closely related to other inflammatory conditions in the region, namely orbital pseudotumour and Tolosa-Hunt syndrome.