Cystic pituitary adenoma and meningioma

Case contributed by A.Prof Frank Gaillard

Presentation

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Patient Data

Age: 55 years
Modality: MRI

Pituitary lesion has a solid left sided enhancing component which is greater than can be accounted for by normal pituitary tissue. The differential diagnosis is therefore between an adenoma with eccentric cystic component, or less likely a craniopharyngioma.

Meningioma with hyperostosis also noted. 

Case Discussion

The patient went on to have surgery.

Histology

MICROSCOPIC DESCRIPTION

Pituitary: The sections show a moderately cellular pituitary adenoma comprising nests and perivascular pseudorosettes, surrounded by vascularised stroma. The tumour cells have mildly enlarged round nuclei, finely granular chromatin and moderate amounts of eosinophilic cytoplasm. There are no atypical features. Normal anterior pituitary gland tissue is present. The tumour cells are positive for FSH. Immunostains for the other pituitary hormones are negative. The Ki-67 index is about 2%.

Meningioma: Paraffin sections show a moderately hypercellular meningioma with a mixed syncytial and fibroblastic architecture. In addition, there are numerous hyalinised and calcified psammoma bodies. Tumour cells have uniform nuclear features. No mitotic figures are identified and there is no necrosis. No evidence of brain invasion is seen.

FINAL DIAGNOSIS:

  1. Silent gonadotroph pituitary adenoma
  2. Meningioma
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Case Information

rID: 49382
Case created: 22nd Nov 2016
Last edited: 11th Dec 2016
Inclusion in quiz mode: Included

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