1/106. A case of autoimmune hypophysitis associated with asymptomatic primary biliary cirrhosis.We report a 61-year old male patient with panhypopituitarism complicated with asymptomatic primary biliary cirrhosis (PBC). T1-weighted magnetic resonance imaging demonstrated high intensity of the anterior pituitary gland. There was no mass lesion or enlargement of the pituitary gland or the stalk. Immunoblot analysis of the patient's sera with rat pituitary antigens revealed a band with a molecular size of 22 kD. Anti-M2 mitochondrial antibody has been consistently positive for five years. liver biopsy revealed portal hepatitis with periportal infiltration of the inflammatory cells. This is the first case report of autoimmune hypophysitis complicated with asymptomatic PBC.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/106. hyponatremia-induced metabolic encephalopathy caused by Rathke's cleft cyst: a case report.Rathke's cleft cysts are sometimes associated with aseptic meningitis or metabolic encephalopathy due to hyponatremia. We treated such a case manifest by lethargy, fever and electroencephalographic abnormalities. A 68-year-old man was admitted to our ward after experiencing general malaise, nausea and vomiting and then high fever and lethargy. On admission, he was drowsy and had nuchal rigidity and Kernig's sign. Physically, he was pale with dry, thickened skin. He had lost 5.0 kg of body weight in the last month. His serum sodium was 115 mEq/l. He had a low serum osmotic pressure (235 mOsmol/l) and a high urine osmotic pressure (520 mOsmol/l). His urine volume was 1200-1900 ml/24 h with a specific gravity of 1008-1015. The urine sodium was 210 mEq/l. He did not have an elevated level of antidiuretic hormone. Electroencephalograms showed periodic delta waves over a background of theta waves. With sodium replacement, the patient become alert and symptom free, and his electroencephalographic findings normalized. However, the serum sodium level did not stabilize, sometimes falling with a recurrence of symptoms. magnetic resonance imaging clearly delineated a dumbbell-shaped intrasellar and suprasellar cyst. The suprasellar component subsequently shrunk spontaneously and finally disappeared. An endocrinologic evaluation showed panhypopituitarism. The patient was given glucocorticoid and thyroxine replacement therapy, which stabilized his serum sodium level and permanently relieved his symptoms. A transsphenoidal approach was performed. A greenish cyst was punctured, and a yellow fluid was aspirated. The cyst proved to be simple or cubic stratified epithelium, and a diagnosis of Rathke's cleft cyst was made. The patient was discharged in good condition with a continuation of hormonal therapy. Rathke's cleft cyst can cause aseptic meningitis if the cyst ruptures and its contents spill into the subarachnoid space. Metabolic encephalopathy induced by hyponatremia due to salt wasting also can occur if the lesion injures the hypothalamus and pituitary gland.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
3/106. Papillary thyroid carcinoma metastatic to the pituitary gland.Many malignancies may present with metastases to the pituitary gland. The association of thyroid carcinoma with pituitary metastases is, however, very rare. This report describes two patients in whom metastases from a papillary thyroid carcinoma to the pituitary gland resulted in panhypopituitarism with blunted endogenous thyrotropin (TSH) production following withdrawal of levothyroxine. Both required the use of recombinant human TSH prior to radioiodine therapy. Symptoms of hypopituitarism may be difficult to distinguish clinically from those of hypothyroidism in the setting of levothyroxine withdrawal. Clinicians should be aware of the clinical and biochemical manifestations of this rare association.- - - - - - - - - - ranking = 3keywords = gland (Clic here for more details about this article) |
4/106. Adrenal and hypophyseal non-Hodgkin's lymphoma presenting with panhypopituitarism.We report a case of non-Hodgkin's lymphoma presenting as anterior pituitary failure and found to have involvement of two endocrine glands, the pituitary and the adrenals.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
5/106. Successful pregnancy by intracytoplasmic sperm injection after radiotherapy-induced azoospermia.A 27-year-old male, who underwent excision and radiotherapy for a pineal gland germinoma four years previously, subsequently developed panhypopituitarism and, thus, complete azoospermia. Gonadotrophin replacement therapy resulted in the production of a small number of motile spermatozoa which were used for Intracytoplasmic Sperm Injection (ICSI) into oocytes obtained from his wife. After successful fertilization and embryo transfer, a singleton intrauterine pregnancy was achieved which resulted in the normal delivery of a morphologically normal male live infant at term.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
6/106. MR imaging in children with ectopic pituitary gland and anterior hypopituitarism.Posterior pituitary ectopia refers to an absent normal posterior pituitary bright spot within the sella with ectopic bright signal at another site (such as the median eminence) on a weighted magnetic resonance. We describe two children with idiopathic anterior hypopituitarism who showed an ectopic posterior pituitary and absent pituitary stalk on imaging. We emphasize the association of the absent pituitary stalk in ectopic pituitary gland and low growth hormone levels.- - - - - - - - - - ranking = 2.5keywords = gland (Clic here for more details about this article) |
7/106. Multifocal fibrosclerosis as a possible cause of panhypopituitarism with central diabetes insipidus.Multifocal fibrosclerosis denotes a combination of similar fibrous disorders occurring at different anatomical sites. We encountered a 53-year-old male patient with orbital pseudotumor, chronic paranasal sinusitis, fibrous nodules of the lungs, intracranial pachymeningitis, and panhypopituitarism with central diabetes insipidus (DI) as a possible manifestation of multifocal fibrosclerosis. It has been reported that intracranial pachymeningitis or orbital pseudotumor associated with multifocal fibrosclerosis could invade the sella turcica causing a variety of anterior and/or posterior pituitary dysfunctions. In our case, intracranial pachymeningitis apparently involved the pituitary stalk and gland. Isolated gonadotropin deficiency, in addition to central DI, preceded panhypopituitarism. Although panhypopituitarism with central DI due to multifocal fibrosclerosis is quite rare and only one case has ever been reported, this systemic fibrotic disorder can be a possible cause of panhypopituitarism with central DI.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
8/106. Lymphocytic hypophysitis masking a suprasellar germinoma in a 12-year-old girl--a case report.Case history, light and electron microscopic findings of a case of a lymphocytic hypophysitis in coincidence with a suprasellar germinoma in a 12-year-old girl are reported. The girl presented with a long time case history of diabetes insipidus and subsequent panhypopituitarism. Two years after the diagnosis of diabetes insipidus magnetic resonance imaging (MRI) showed a tumorous enlargement of the sellar content and pituitary stalk. A transnasal exploration was initially performed and revealed a lymphocytic hypophysitis. light microscopy showed a dense infiltration of mature lymphocytes and plasma cells in the interstitium of the anterior pituitary gland. The stalk area could not be exposed to exclude a germinoma. One year later the lesion relapsed despite dexamethason therapy and a second operation by another neurosurgeon had to be performed. light microscopy showed lymphocytic infiltrates, fibrosis and necrosis. The diagnosis was a lymphocytic hypophysitis again. Though transcranially exposed only pituitary tissue was removed. No infundibular mass became visible at surgery as shown by MRI. The girl developed five months later multiple cerebral lesions, which revealed to be a germinoma. Lymphocytic hypophysitis in children is very rare and a coincidence with a germinoma has not been described from histopathological aspect until now. The origin of the pituitary infiltration is discussed.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
9/106. Lymphoid "hypophysitis" with end organ insufficiency.A clinically hypothyroid patient had bi-lateral adrenal cortical atrophy and an extraordinary lesion of the pituitary gland. The parenchyma of the adenohypophysis was extensively replaced by a predominantly lymphocytic infiltrate with formation of nodules, many of which had pale germinal centers. There were areas of hyalinization with interstitial fibrosis and mildcapsular thickening. A similar lesion of the adenohypophysis has been reported previously, but without the evidence of adenohypophyseal insufficiency present in this case. It is speculated that this lesion may be related to cell-mediated autoimmunity and other organ-specific autoimmune disorders.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
10/106. hypopituitarism due to pituitary metastasis of lung cancer: case of a 21-year-old man.A 21-year-old man presented persistent dry cough, general malaise, loss of appetite, decreased sexual desire and double vision. Chest radiograph revealed a mass shadow in the left upper lobe. Histopathological diagnosis of the tumor was squamous cell carcinoma. brain computed tomography and magnetic resonance imaging revealed a metastasis to the pituitary gland. hypopituitarism was diagnosed by pituitary function tests. diabetes insipidus was absent and the function of the posterior lobe of the pituitary gland was preserved. hypopituitarism due to pituitary metastasis is a rare complication of lung cancer, and has never been reported in a patient as young as 21 years old.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
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