LYMPHOCYTIC HYPOPHYSITIS IN A PATIENT WITH GRAVES-DISEASE

A case of lymphocytic hypophysitis is described in a patient with Grav es' disease and diabetes mellitus. The 62-year-old man was admitted to hospital with the complaints compatible with hyperthyroidism in April 1993. His medical history, physical examination, thyroid function tes ts, thyroid scintigraphy and thyroid ultrasonography revealed Graves' disease. The patient had also suffered from diabetes mellitus for thre e years, After this, the patient's progress was not monitored for two years. The patient presented himself again in September 1995 with comp laints of hypothyroidism, hypogonadism and hypoadrenalism. Hormonal in vestigation showed panhypopituitarism. A magnetic resonance imaging of the pituitary gland disclosed an enlarged pituitary and a thickened i nfundibulum. The high intensity signal of the neurohypophysis was abse nt. Transsphenoidal hypophysectomy was performed which revealed a grey -white, relatively avascular pituitary mass. Histology showed diffuse infiltration of the anterior pituitary by numerous lymphocytes, The ne urohypophysis also showed evidence of lymphocytic infiltration. On the basis of these findings we suggest that lymphocytic hypophysitis may be associated with Graves' disease. (C) 1998, Editrice Kurtis.