Presentation
Amenorrhea. Elevated serum prolactin levels.
Patient Data
There is well-defined T2w slightly hyperintense nodule (with superior contour bulge) in the right half of anterior pituitary gland measuring 5.0 x 5.4 x 5.3 mm (AP x TR x CC). The nodule is hypoenhancing as compared to rest of the gland on dynamic contrast study in second and third phases. No parasellar or infrasellar extension was seen.
Rest of the brain appeared normal.
These imaging features in the setting of hyperprolactinemia are suggestive of pituitary microadenoma.
Case Discussion
MRI of pituitary gland with dynamic contrast study is a must in the evaluation of hyperprolactinemia. The microadenoma will show hypoenhancement as compared to rest of the gland on dynamic contrast study, better appreciated in second and third phases.
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