99 research outputs found
Lymphocytic Adenohypophysitis Simulating a Pituitary Adenoma in a Pregnant Woman
The lymphocytic hypophysitis, appearing in women during the third trimester of
pregnancy or early post-partum period, is a rare cause of hypopituitarism and pituitary
enlargement. A 39 year-old woman presented in the 37th week of pregnancy with bilateral
heteronymous quadrantanopsia, CT indicative of tumorous mass and symptoms of
hypopituitarism with decreased thyroid hormone and thyrotrophin levels, and low normal
level of cortisol. After the birth of a healthy male child the patient breastfed for 10
days, sight disturbances disappeared, but amenorrhea persisted. Upon admittance the
visual field showed no abnormalities. MR of the sellar region confirmed previous CT
findings. Endocrinological testing confirmed secondary hypothyroidism and cortisol
deficiency, normal levels of prolactin with satisfactory reaction to thyroliberin. Histology
showed mononuclear infiltration, and immunohistochemistry revealed T-cells (CD3)
at the borders, and B-cells (CD20) in the follicular center. Due to enlargement of the pituitary
associated with hypopituitarism, an incorrect diagnosis of a tumor could be mad
Chiasma Syndrome in Acromegalic Patients – Correlation of Neuroradiologic and Neuroophthalmologic Findings
The study evaluated neuroophthalmologic and computerized tomography (CT) findings
in 100 patients with somatotrophic adenoma and clinical picture of acromegaly,
who underwent transsphenoidal adenomectomy. Prior to the surgery, visual field was
normal in 77 patients. The diameter of adenoma in these patients ranged from 8 to 30
mm on CT, and the average value was 13.5 mm. Various kinds of visual field disturbances
were present in 23 patients. The diameter of their adenomas ranged between 18
to 35 mm, with the average of 24.7 mm. Compared to visual field defects, CT findings of
suprasellar adenoma extension were better correlated with chiasma syndrome (p < 0.001).
All patients with suprasellar mass greater than 10 mm had chiasma syndrome. Degenerative
adenoma changes (hemorrhagic necrosis), which precipitate abrupt increase in
size of the tumor, were more frequently seen in patients with chiasma syndrome. The incidence
of chiasma syndrome directly correlates with the degree of suprasellar extension
of the tumor
Imaging of ependymomas: MRI and CT
The imaging features of intracranial and spinal ependymoma are reviewed with an emphasis on conventional magnetic resonance imaging (MRI), perfusion MRI and proton magnetic resonance spectroscopy, and computed tomography. Imaging manifestations of leptomeningeal dissemination of disease are described. Finally, salient imaging features obtained in the postoperative period to evaluate completeness of surgical resection, and thereafter for long-term surveillance for disease recurrence, are reviewed
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