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Purpose:
This study aimed to investigate the relation of magnetic resonance image (MRI) features and immunohistochemistrical subtypes of pituitary microadenomas (PMAs) characterized by location and growth pattern.
Materials and methods:
A double-center, retrospective review of MRI characteristics was conducted in 57 PMA cases recorded from February 2014 to September 2023 and identified on the basis of 2017 WHO classification of pituitary gland tumors. The geometric center of the tumor was defined, and the possibility of PMA vertical or lateral growth pattern was evaluated according to ratio of maximum diameter between the X and Y axes.
Results:
Among the PMAs, somatotroph adenomas (STAs) significantly frequented the lateral–anteroinferior portion of pituitary gland (P=0.036). Lactotroph adenomas (LTAs) showed significant locational preference for the lateral–posteroinferior portion (P=0.037), and gonadotroph adenomas (GTAs) were predominately located in the central–anteroinferior portion (P=0.022). Furthermore, the PMAs in the suprasellar portion exhibited vertical extension with statistical significance (P=0.0).
Conclusion:
In our cohort, the micro-STAs were predominately located in the lateral–anteroinferior portion of pituitary gland, the micro-LTAs in the lateral–posteroinferior portion, and the micro-GTAs in the central–anteroinferior portion. The growth pattern of the PMAs was highly correlated with their vertical position instead of their immunohistochemistrical subtypes. Therefore, MRI shows potential in differentiating partial PMA subgroups, especially the cases in silent groups.
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Aim: To define functional and anatomical pituitary disease following ICI therapy and describe any change in pituitary function with time.
Methods: Retrospective observational audit of patients on ICI therapy in our centre between 2013 and 2023. We reviewed all patients on ICI therapy under the oncology department at University Hospital Plymouth, and identified individuals referred to endocrinology with suspected adrenal insufficiency. Patients were established on adrenal steroid replacement and subsequently underwent formal pituitary testing. Pituitary disease was evidenced by low ACTH, other pituitary dysfunction and/or abnormalities on pituitary imaging.
Results: 954 patients received ICI therapy during the study period, and 37 developed HPA axis dysfunction. Median interval of onset of symptoms was 4 months. There was no recovery in cortisol or ACTH for any individual on repeated testing. Other permanent anterior pituitary hormone defects were unusual. Hypophysitis associated with immunotherapy appears to specifically target corticotrophs with no evidence of recovery. There was a specific abnormality seen in MRI scans of 7 of 27 patients who had scans, appearing to be a particular feature of immune mediated hypophysitis. These were confined to the anterior aspect of the pituitary as striations and were not visible on any scans performed more than three months after disease onset.
Conclusion: These data show that immune related (IR) hypophysitis is a common complication of immune checkpoint inhibitor therapy. This may result in an imaging abnormality within the areas of the pituitary richest in corticotrophs. The endocrine consequence of this is a permanent defect in ACTH and therefore cortisol production.
National Hospital for Neurology and Neurosurgery, London, UK
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National Hospital for Neurology and Neurosurgery, London, UK
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visual acuity and fields Further neuro-ophthalmic assessments can be undertaken when the patient is clinically stable CT brain (± LP) to exclude SAH and meningitis should be undertaken if not already done Magnetic resonance imaging (MRI) is the
Division of Epidemiology and Biometry, Carl von Ossietzky University, Oldenburg, Germany
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Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
Department of Pediatrics, McMaster Children’s Hospital and McMaster University, Hamilton, Ontario, Canada
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in this age group, while the papillary type is almost only prevalent in adults ( 1 ). The diagnosis of CP in the fetal and neonatal periods is uncommon. Due to modern and noninvasive diagnostic techniques such as MRI and high-quality ultrasound
Centre for Endocrinology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Department of Paediatric Endocrinology, Royal London Hospital, Barts Health NHS Trust, London, UK
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Centre for Endocrinology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Centre for Endocrinology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Department of Paediatric Endocrinology, Royal London Hospital, Barts Health NHS Trust, London, UK
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results. Radiological imaging Abdominal ultrasound (US) or magnetic resonance imaging (MRI) of the neck, chest, abdomen and pelvis was performed annually, as previously described ( 11 ). The imaging was reviewed on two separate occasions as
Division of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Department of Exercise Physiology, Child Development & Exercise Center, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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Department of Radiology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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Department of Radiology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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Department of Exercise Physiology, Child Development & Exercise Center, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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Division of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Institute of Mathematics, Leiden University, Leiden, The Netherlands
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Division of Pediatric Oncology, University Medical Centre Groningen, Groningen, The Netherlands
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Division of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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hard to predict. The differences in outcome of these children may be explained by damage to different hypothalamic nuclei, and it is uncertain in which children the REE is reduced ( 5 ). For radiological scoring of hypothalamic damage, several MRI
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Department of Pathological Cytology and Anatomy, Foch Hospital, Paris, France
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of his face, headache and fatigue. Ophthalmological evaluation revealed bitemporal hemianopia, more pronounced on the left side. Pituitary MRI was performed showing a pituitary macroadenoma measuring 25 mm in its largest diameter, compressing the
Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Castellón, Spain
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been described in the literature, depending on the characteristics of the adenoma (aggressivity and spread, histology, size, magnetic resonance imaging (MRI) identification of the adenoma, etc.), surgery and the experience of the neurosurgeon and
Department of Neurosurgery, Rui-Jin Lu-Wan Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Department of Neurosurgery, Rui-Jin Lu-Wan Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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College of Information Technology and Engineering, Chengdu University, Chengdu, China
College of Computer Science, Sichuan Normal University, Chengdu, Sichuan, China
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and pneumoencephalography reports ( 4 , 5 ). The introduction of MRI enabled a more accurate assessment of brain structures. Previous MRI studies have already demonstrated the relationship between hypercortisolism and whole-brain damage ( 2 , 6
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Green Templeton College, University of Oxford, Oxford, UK
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radiologic features ( 4 , 8 ) except the rarely reported early intense contrast enhancement (’Hasiloglu’s sign’) or the presence of proteinaceous material appearing as a T1-hypointensity on MRI (’star crack sign’) ( 9 , 10 ). These tumours are in fact, more
