LYMPHOCYTIC ADENOHYPOPHYSITIS - MAGNETIC-RESONANCE-IMAGING FEATURES OF 2 NEW CASES AND A REVIEW OF THE LITERATURE

Lymphocytic adenohypophysitis can cause pituitary expansion and hypopi tuitarism closely mimicking the features of a pituitary adenoma. Discr imination between these two conditions is of importance since, despite the similarity of their presentation, there are significant differenc es in pathophysiology. In contrast to pituitary adenoma, lymphocytic a denohypophysitis occurs almost exclusively in young women in relation to pregnancy, there is a preference for destruction of ACTH and TSH se creting cells and computed tomographic scanning shows uniform contrast enhancement in a proportion of cases. There is, as yet, no proven spe cific non-surgical treatment, There are anecdotal reports of a benefic ial effect of steroids but there is also evidence that spontaneous res olution may occur. We have reviewed the literature and report two new cases of lymphocytic adenohypophysitis both of whom exhibited early st riking diffuse homogeneous contrast enhancement on magnetic resonance imaging scanning which we suggest may be a diagnostic feature of this condition.