Noninfectious Inflammatory Lesions of the Sellar Region

Lymphocytic Hypophysitis

Lymphocytic hypophysitis is a destructive inflammatory disorder of the anterior pituitary, presumed to be autoimmune in origin. Although the earliest descriptions of this condition stemmed from necropsy studies wherein the potentially lethal nature of the disorder was emphasized, improved recognition of the condition, coupled with hormone replacement therapy, has since rendered lym-phocytic hypophysitis an entirely treatable condition.

The basic lesion consists of a destructive inflammatory infiltrate of lymphocytes, plasma cells, and macrophages that is restricted exclusively to the anterior lobe of the gland. The result is a firm and enlarged gland that often extends into the suprasellar space and microscopically exhibits effacement of the normal glandular architecture and disruption of the structural and immunohistochemical integrity of all anterior lobe secretory elements (177). Lymphoid follicles and loosely organized germinal centers may be present, as are varying degrees of

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