Abstract：
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.
journal_name
Neuroradiologyjournal_title
Neuroradiologyauthors
Nishioka H,Shibuya M,Ohtsuka K,Ikeda Y,Haraoka Jdoi
10.1007/s00234-010-0675-8subject
Has Abstractpub_date
2010-11-01 00:00:00pages
997-1002issue
11eissn
0028-3940issn
1432-1920journal_volume
52pub_type
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