INTRODUCTION: The study aims to describe the endocrinological and magnetic resonance imaging (MRI) features of the rarely reported xanthogranulomas associated with pituitary adenoma. METHODS: Of 231 consecutive pituitary adenomas treated surgically, those with xanthogranulomatous reaction on histology were reviewed. RESULTS: Five patients (2.2%) had an adenoma with marked xanthogranulomatous reaction. They were all nonfunctioning macroadenomas and presented with anterior pituitary insufficiencies. On MRI, all adenomas showed mixed signal intensities on T1- and T2-weighted images with heterogeneous gadolinium enhancement, reflecting their complex histological features: Cholesterol clefts typically showed T1 high- and T2 low-signal intensities. Preoperative diagnosis was difficult in a case predominantly featuring xanthogranuloma. Although none of them had episodes of pituitary apoplexy, hemosiderin deposits and cysts with xanthochromic-like fluid were observed in five and four cases, respectively. CONCLUSIONS: Xanthogranulomatous reaction may develop in macroadenomas, probably triggered by hemorrhagic processes despite no apoplectic episodes. They typically exhibit complex mixed signal intensity on MRI, particularly T1 high- and T2 low-signal intensities, and patients present with pituitary dysfunction.
INTRODUCTION: The study aims to describe the endocrinological and magnetic resonance imaging (MRI) features of the rarely reported xanthogranulomas associated with pituitary adenoma. METHODS: Of 231 consecutive pituitary adenomas treated surgically, those with xanthogranulomatous reaction on histology were reviewed. RESULTS: Five patients (2.2%) had an adenoma with marked xanthogranulomatous reaction. They were all nonfunctioning macroadenomas and presented with anterior pituitary insufficiencies. On MRI, all adenomas showed mixed signal intensities on T1- and T2-weighted images with heterogeneous gadolinium enhancement, reflecting their complex histological features: Cholesterol clefts typically showed T1 high- and T2 low-signal intensities. Preoperative diagnosis was difficult in a case predominantly featuring xanthogranuloma. Although none of them had episodes of pituitary apoplexy, hemosiderin deposits and cysts with xanthochromic-like fluid were observed in five and four cases, respectively. CONCLUSIONS:Xanthogranulomatous reaction may develop in macroadenomas, probably triggered by hemorrhagic processes despite no apoplectic episodes. They typically exhibit complex mixed signal intensity on MRI, particularly T1 high- and T2 low-signal intensities, and patients present with pituitary dysfunction.
Authors: M Stojanovic; E Manojlovic-Gacic; S Pekic; T Milojevic; D Miljic; M Doknic; M Nikolic Djurovic; Z Jemuovic; M Petakov Journal: Acta Endocrinol (Buchar) Date: 2019 Apr-Jun Impact factor: 0.877
Authors: Vera Lozovanu; Carmen Emanuela Georgescu; Lavinia Maria Florescu; Carmen Georgiu; Horatiu Silaghi; Andrian Fratea; Cristina Alina Silaghi Journal: J Pers Med Date: 2022-06-08
Authors: Jaya Sujatha Gopal-Kothandapani; Veejay Bagga; Stephen B Wharton; Daniel J Connolly; Saurabh Sinha; Paul J Dimitri Journal: Endocrinol Diabetes Metab Case Rep Date: 2015-01-01