Pituitary hyperplasia

Discussion:

Pituitary hypophysitis is divided into:

  • lymphocytic: is the most common form and  has an autoimmune pathogenesis. It is frequently observed in women during their late pregnancy or in the early postpartum period
  • granulomatous: pathogenesis remains uncertain and does not have the epidemiology related to women and pregnancy

On imaging, they present as symmetric and homogeneous pituitary enlargement, with vivid and homogenous enhancement, usually enlarging the stalk. It has been described that hypophysitis also shows loss of the posterior pituitary bright spot due to the autoimmune involvement 1

Adenomas, on the other hand, are typically asymmetric and show a heterogeneous enhancement due to its cystic or necrotic areas.

This case was assumed to be a hyperplastic pituitary gland related to the pregnancy and was confirmed to improve in a few months after the delivery. The patient had normal hormones values at the time of the last scan. 

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