Lymphocytic hypophysitis

Case contributed by Dalia Ibrahim
Diagnosis possible


Diabetes insipidus.

Patient Data

Age: 30 years
Gender: Female
  • absent high T1 signal of the posterior pituitary gland
  • thickened intensely enhancing infundibulum with loss of its inferior tapering.

Case Discussion

Her laboratory work-up revealed hypokalemia. Her hormonal profile revealed reduced ADH. The patient didn't suffer any systemic disease.

Diagnosis, in this case, is presumptive depending on the clinical, laboratory, and radiological features of the disease.

Radiological features which could differentiate lymphocytic hypophysitis from pituitary adenoma:

  • absent posterior pituitary high signal on non-contrast T1 WI
  • thickened enhancing pituitary stalk
  • bulky pituitary gland showing homogenous enhancement with no focal lesions
  • dural tail sign
  • parasellar dark signal encasing the pituitary

Differential diagnosis

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