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Case #24

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Demographics: 33 years old, Female
Indication: Diabetes insipidus, status post brain biopsy

Case #24

Findings

  • Abnormal enhancement and thickening of the pituitary stalk and of the hypothalamus bilaterally
  • Linear area of T2 hyperintensity extending through the left frontal lobe to the hypothalamus, consistent with a biopsy track
  • No evidence of acute infarct, hemorrhage, mass effect, or hydrocephalus
  • Normal appearance of the pituitary gland

Diagnosis

Lymphocytic hypophysitis (infundibulohypophysitis)

Sample Report

Abnormal enhancement and thickening of the pituitary stalk and of the hypothalamus bilaterally, for which the differential diagnosis includes lymphocytic hypophysitis, neoplasm such as lymphoma or germinoma, or granulomatous process such as sarcoidosis or Langerhans cell histiocytosis.

No evidence of acute infarct, hemorrhage, mass effect, or hydrocephalus.

Normal appearance of the pituitary gland.

Discussion

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References

  • Catford S, Wang YY, Wong R. Pituitary stalk lesions: systematic review and clinical guidance. Clin Endocrinol 2016; 85(4): 507-521.
  • Saleem SN, Said AH, Lee DH. Lesions of the hypothalamus: MR imaging diagnostic features. Radiographics 2007; 27(4): 1087-1108.
  • Yoon SC, Shin CH, Yang SW, Lee SY. Clinical and radiological features of pituitary stalk lesions in children and adolescents. Ann Pediatr Endocrinol Metab 2014; 19(4): 202-207.

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