Presentation
Adult male presenting with bitemporal hemianopia.
MRI demonstrates a mass arising out of the pituitary fossa and contacting the optic chiasm. It is of intermediate signal on T1 and FLAIR sequences and enhances homogeneously. Features are consistent with a pituitary macroadenoma.
Case Discussion
The patient went on to resection which confirmed the diagnosis of null cell pituitary adenoma.
Histology
Paraffin sections show fragments of a moderately hypercellular adenoma. This is composed of cells with round and oval vesicular nuclei and a moderate amount of pale cytoplasm, arranged in diffuse sheets intersected by thin-walled capillaries. No mitotic figures or areas of necrosis are seen. Scattered acini of normal anterior pituitary cells are admixed with tumor.
No immunostaining for growth hormone, prolactin, ACTH, FSH, LH or TSH is seen in tumor cells. The features are of null cell adenoma.
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