Pituitary macroadenoma with necrosis

Case contributed by A.Prof Frank Gaillard

Presentation

Visual disturbance.

Patient Data

Age: Adult
Gender: Male

MRI pituitary

Modality: MRI

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. 

Histology

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 haemorrhage is not infrequently seen. 

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Case Information

rID: 5368
Case created: 8th Jan 2009
Last edited: 5th Jan 2016
Inclusion in quiz mode: Included

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