Pituitary macroadenoma - necrotic

Case contributed by Assoc Prof Frank Gaillard


Visual disturbance.

Patient Data

Age: Adult
Gender: Male

MRI pituitary

A mass expands the pituitary fossa. It is centrally of fluid signal with thick nodular peripheral contrast enhancing tissue. The optic chiasm is pushed superiorly and distorted. The mass also invades the right cavernous sinus. 

This patient went on to have a transphenoidal resection. 


Most of the tissue fragments are composed of uniform cells with round nuclei and abundant granular cytoplasm arranged in solid sheets and papillary structures. Rare mitotic figures are identified. Small fragments of atrophic adenohypophysis are also present. Immunohistochemistry for pituitary hormones shows the tumor to have moderately intense, focal positivity for LH.

Final diagnosis: pituitary adenoma (focal reactivity for LH).

Case Discussion

Although most macroadenomas are solid, cystic change due to necrosis or prior hemorrhage is not infrequently seen. 

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Case information

rID: 5368
Published: 8th Jan 2009
Last edited: 13th Aug 2019
Inclusion in quiz mode: Included

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