Pituitary hyperplasia refers to the diffuse pituitary enlargement that can be physiological in young menstruating females or pregnant/lactating women or, less commonly, secondary to end-organ failure.
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Pathology
The upper limit of normal pituitary height varies with age and gender 1:
infants, children: 6 mm
males and postmenopausal women: 8 mm
young menstruating females: 10 mm
pregnant/lactating women: 12 mm
Non-physiologic pituitary hyperplasia is commonly caused by an end-organ failure such as hypothyroidism 3, Addison disease 4 and neuroendocrine tumors 5. Medications such as estrogen, GnRH analogs and antipsychotics can cause or exacerbate pituitary hyperplasia 5.
Radiographic features
The pituitary gland can be assessed both by CT and MRI dedicated protocols, which can show the following: 1
enlarged homogeneously enhancing pituitary gland with a convex superior margin
size: >10 mm up to 15 mm
may be globular/nodular, mimicking pituitary adenoma
Treatment and prognosis
Only surveillance is suggested until reversal of the underlying pathological condition as pituitary hyperplasia rarely progresses 5.
Differential diagnosis
venous congestion as seen in intracranial hypotension
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