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Journal of Neurosurgical Sciences 1999 September;43(3):205-9

language: English

Lymphocytic hypo­phy­sitis. Case ­report

Ruelle A. 1, Bernasconi D. 2, Tunesi G. 3, Andrioli G. 1

1 Divisione di Neurochirurgia, Ospedale Galliera, Genova;
2 Servizio di Endocrinologia, Ospedale Galliera, Genova;
3 Servizio di Anatomia Patologica, Ospedale Galliera, Genova


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Lymphocytic hypo­phy­sitis is a very unusu­al dis­ease typ­i­cal­ly ­observed in the per­i­par­tum peri­od but found also in non-preg­nant women or in men. We ­report the case of a 50-year-old wo-man with a five-year his­to­ry of erit­he­ma nodo­sus for which was treat­ed with var­i­able doses of ster­oids. One year ­before admis­sion the ­patient began to com­plain of head­ache, ame­nor­rhea and rap­id­ly pro­gres­sive hypo­pi­tui­tar­ism. Ma-gnetic res­o­nance imag­ing ­showed an expand­ing sel­lar mass with homo­ge­ne­ous con­trast enhan-ce­ment while lack­ing the hyper­in­tense sig­nal of pos­te­ri­or lobe. The MRI find­ings and the his­to­ry of auto­im­mune dis­ease ­raised the sus­pi­cion of hypo­phy­sitis. The ­growth of the ­lesion and its unre­spon­sive­ness to the pro­longed ster­oid ther­a­py made sur­gery, which is both diag­nos­tic and ther­a­peu­tic, man­da­to­ry. The path­o­gen­e­sis, diag­no­sis and man­age­ment of this unusu­al clin­i­cal con­di­tion are dis­cussed.

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