黄色瘤样垂体炎MRI表现:病例报告及文献复习（英文）

MRI manifestation of xanthomatous hypophysitis: A case report and review of the literature

黄色瘤样垂体炎临床上极少见。1例33岁女性患者,因头痛、视力障碍、停经入院,实验室内分泌学检查提示皮质功能减退;MRI检查表现为鞍区占位,T1WI呈等信号,T2WI为略高信号,增强后病变明显均匀强化,垂体柄增粗,视交叉被向上推压移位,左侧海绵窦受侵,肿块包绕左侧颈内动脉,冠状位上略呈"三角形"。术前诊断为垂体腺瘤,在全身麻醉下行鞍区及鞍上占位病变切除术+视神经减压术,病理检查表现为镜下见间质泡沫细胞、淋巴浆细胞、粒细胞明显增生,支持黄色瘤样垂体炎。黄色瘤样垂体炎的MRI表现有一定的特征性,其最典型的MRI特点是垂体柄增粗及由于增粗的垂体柄、侵犯海绵窦而在MRI冠状位上表现为"三角形"。分析其影像学特点有助于提高诊断的准确性及选择适宜的治疗方案。

The inflammatory lesion of the pituitary gland is unusual. A 33-year-old woman with headache, visual impairment, and menelipsis was admitted to the Second Xiangya Hospital, Central South University. The results of magnetic resonance imaging(MRI) for pituitary gland showed a sellar mass with iso-intensity on T1 weighted imaging and high signal on T2 weighted imaging. The homogeneous lesion was enhanced on contrast MRI. The pituitary stalk was thickened accompanied by the cavernous sinus invasion, which showed a 'triangle' saddle occupation on the MRI coronal plane. An endocrinological examination revealed mild hypocortisolism. The patient was diagnosed as pituitary adenoma based on the MRI findings and endocrinological examination. Trans-sphenoidal surgery was performed. The intra-operative histological examination also suggested a pituitary adenoma. The histopathological examination showed accumulation of foamy cells and xanthomatous epithelioid cells, supporting the diagnosis of xanthomatous hypophysitis. Xanthomatous hypophysitis possesses certain MRI features. The most typical imaging features are the thickening of the pituitary stalk and the sign of 'triangle' occupation on MRI coronal plane, which are very helpful to the correct diagnosis and optimal management.