Hypophysitis Research Center

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Category: Surgery and Histopathology
386 Matching Records
Pt ID Sx Type Sx Complications Pituitary Path Lym Plas Foll Eos Neut Fibs Hist Macr Ede Necr
1 not done 9 Pituitary was smaller than normal. Histology showed extensive lymphocytic infiltration, forming diffuse sheets around atrophic acini and in some places darkly staining aggregates, some with germinal center. The posterior pituitary is normal. The thyroid has the appearance of Hashimoto's thyroiditis. The adrenal glands were not found and presumed to be atrophic. Yes No Yes No No No No No No No
2 not done 9 Pituitary was small (about one-third the normal size) and covered by a thickened fibrous capsule. The pars anterior shows heavy and diffuse lymphocytic infiltration; with only occasional plasma cells. The cellular infiltration is particularly heavy around groups of atrophied acini. Heavy interstitial fibrosis. No giant cells. Thyroid shows small areas of focal chronic thyroiditis. The stomach mucosa is heavily and diffusely infiltrated with lymphocytes. The adrenals are atrophic, with only few cortical cells remaining, but without lymphocytic infiltration in the cortex. Yes Yes No No No Yes No No No No
3 not done 9 Pituitary is enlarged, gray-yellowish and shiny. The cut surface showed many, clearly appearing, darker areas, that on higher power, turned out to be lymphoid follicles. Some with germinal center. Many lymphocytes were also present in the interstitium with few plasma cells, effacing the pituitary architecture. Endocrine cells were atrophic and reduced to small clusters, without any particular tintorial feature. No fibrosis was found. Hypervascularization was noted. The posterior hypophysis is small but unremarkable. Adrenal cortex was atrophic, especially in zona fasciculata and reticularis, without lymphocytic infiltration. The thyroid was of reduced size and without infiltration. Yes Yes Yes No No No No No No No
4 not done 9 Pituitary showed severe changes throughout the anterior lobe. Numerous granulomas made of plump epitheliod cells, and pronounced infiltration with lymphocytes in the remaining parenchyma and also inside the granulomas. Adrenals showed a slightly narrowed cortex and a fairly severe lymphocytic infiltration at the junction between cortex and medulla. Thyroid showed extremely severe lymphocytic infiltration Yes No No No No No No No No No
5 not done 9 Nothing remarkable except for the lung (that showed signed of chronic asthma) and the posterior hypophysis. The posterior hypophysis showed a diffuse fibrosis and a marked infiltration of lymphocytes and plasma cells, with partial formation of lymphoid follicles. No polymorph nuclear cells. A similar change was also observed in the pituitary stalk to a lesser degree. The pituicytes are swollen and the interstitial space widened. The neurohypophysis was edematous as a whole. The anterior hypophysis was normal except for a vacuolar degeneration of basophilic cells, which was probably caused by the prolonged use of steroids for her asthma. Yes Yes Yes No No Yes No No No No
6 not done 9 Pituitary was grossly normal. Histology, however, showed diffuse infiltration by mature lymphocytes, with follicle formation many of which had pale germinal centers. There were also some plasma cells and moderate interstitial fibrosis. Neurohypophysis, infundibulum and hypothalamus were normal. Thyroid showed flattened follicular epithelium, but no lymphocytic infiltration. One parathyroid gland was examined and showed a focal lymphocytic infiltration with a small plasma cell component. The adrenals had a thin cortex and severe hyperemia at the cortico-medullary junction, along with a mild lymphocytic infiltrate. Yes Yes Yes No No Yes No No No No
7 not done 9 Pituitary weighted 500 mg, was flat. The dura was thicker than normal. The anterior lobe was markedly atrophic and infiltrated by mature lymphocytes. There were also clear granulomas and a focus of necrosis. Endocrine cells were small and without secretory granules. The posterior lobe was normal The adrenal glands and thyroid were atrophic, but without lymphocytic infiltration. Yes No No No No Yes No No No No
8 not done 9 The pituitary was enlarged and bulged slightly from the sella. Histology showed in the adenohypophysis diffuse infiltrate of lymphocytes and plasma cells, with some lymphoid follicles. This process destroyed about 75% of the anterior hypophysis. The posterior hypophysis was unremarkable. No abnormalities were detected in the thyroid and the adrenal glands. Also parathyroid and pancreas were normal Yes Yes Yes No No No No No No No
9 not done 9 Hypophysis showed massive infiltration with lymphocytes and plasma cells, especially in the pars intermedia Yes Yes No No No No No No No No
10 Transphenoidal 0 The adenohypophyseal cells are separated by many inflammatory cells, mainly lymphocytes, plasma cells and some eosinophils. Lymphoid follicles were frequently seen. The neurohypophysis was not affected. Yes Yes Yes Yes No No No No No No
11 Transphenoidal 0 The pituitary was subtotally resected. Histology showed lymphocytic infiltration of the adenohypophysis, with lymphoid follicles and fibrosis. Parts of the surgical specimen contained fragments of the neurohypophysis, which was not involved. Yes No Yes No No Yes No No No No
12 not done 9 The pituitary was small (60-70% smaller). Numerous clusters of lymphocytes interspersed with a few plasma cells were distributed throughout the anterior lobe. Smaller aggregates of mononuclear cells were scattered between individual secretory cells. Overall, 5-10% of the anterior pituitary was infiltrated by inflammatory cells. There was hyperplasia of the prolactin cells. The pituitary was made up almost entirely by acidophil and chromophobe cells. No basophilic cells were seen and no ACTH reactivity could be seen. Yes Yes No No No No No No No No
13 Craniotomy (frontal) 1 Surgery, done during the 7th month of pregnancy, revealed a moderate sized mass was seen arising from the pituitary fossa, compressing the optic chiasm; the pituitary capsule was dense and difficult to remove, making total extirpation impossible. Histology showed extensive lymphocytic infiltration in the anterior lobe, with some plasma cells. Neurohypophysis was not present in the biopsies. Yes Yes No No No No No No No No
14 Transphenoidal 1 Histology showed marked diffuse infiltration of the anterior lobe with lymphocytes, accompanied by some plasma cells. Some follicles with germinal centers were noted. The posterior lobe was not present in the biopsy. Yes Yes Yes No No No No No No No
15 not done 9 The pituitary was enlarged , bulging from the sella turcica. Histology showed diffuse interstitial infiltrate of lymphocytes and plasma cells. Several lymphoid follicles were present, many of which had pale germinal centers. The adrenal cortex was atrophic in all layers. The thyroid was normal. Yes Yes Yes No No No No No No No
16 Transphenoidal 0 At surgery no discrete tumor was found, but the gland was abnormally dark. Histology showed extensive stromal fibrosis and diffuse lymphocytic infiltrate, with lymphoid follicles and germinal centers. A small fragment of neurohypophysis was free of inflammatory changes. Yes No Yes No No Yes No No No No
17 Transphenoidal 1 When the dura was incised, a firm, dull white mass was seen. Histology showed striking infiltration of the entire pituitary by lymphocytes, plasma cells and scattered eosinophils, accompanied by diffuse fibrosis. Yes Yes No Yes No Yes No No No No
18 Transphenoidal 1 When the dura was incised, a firm, yellow mass, with areas of orange and gray specks, was noted. It was impossible to separate normal gland from abnormal tissue. The mass was biopsied without attempting radical excision. Histology showed extensive fibrosis and numerous infiltrating lymphocytes and plasma cells. Yes Yes No No No Yes No No No No
19 Craniotomy (frontal) 0 Surgery, performed after delivery, revealed a firm, minimally vascular mass with an unusual grayish-yellow appearance. Histology showed only adenohypophyseal tissue. Acinar cells were separated by connective tissue and an extensive infiltrate composed mainly of lymphocytes, plasma cells and a few scattered eosinophils. Lymphoid follicles were present. No granulomas. Yes Yes Yes Yes No No No No No No
20 not done 9 not done NR NR NR NR NR NR NR NR NR NR
21 Transphenoidal 0 Surgery, performed 10 months after delivery, revealed a fibrotic, adherent, pituitary tissue. No tumor was found. Histology showed diffuse infiltration with lymphocytes and a few plasma cells. Yes Yes No No No No No No No No
22 not done 9 Histology showed lymphocytes clearly contacting residual endocrine cells with destroyed reticulin. Lymphocytes organized in follicles with germinal centers. No evidence of infection, giant cells, neutrophils or granulomas. Immunohistochemistry revealed PRL cell hyperplasia, nodular TSH cell hyperplasia, decreased GH, ACTH and LH/FSH cells. Thyroid showed Hashimoto's thyroiditis. Adrenals showed cortical atrophy. Yes No Yes No No No No No No No
257 not done 9 not done NR NR NR NR NR NR NR NR NR NR
258 not done 9 not done NR NR NR NR NR NR NR NR NR NR
259 Craniotomy (right pterional) 0 Surgery showed a thickened pituitary stalk, which was incised. In the stalk a gray-white mass was detected. This mass was removed while protecting the pituitary stalk. Histology showed diffuse infiltration with lymphocytes and also plasma cells. No evidence of granulomas, giant cells or neoplastic tissue. The diagnosis was lymphocytic infundibulo-neurohypophysitis. Yes Yes No No No No No No No No
260 Transphenoidal 1 Surgery showed a gray-white, non-bleeding, mass in the sella. No normal pituitary was detected. The mass did not have the appearance of an adenoma. A frozen section of the mass indicated lymphocytic hypophysitis, and sellar decompression was achieved. Histology showed a diffuse lymphocytic infiltration. Cells were all CD45+, 10% were CD20+ and none was CD3+. Yes No No No No No No No No No
261 Transphenoidal 0 Surgery showed a very hard and thick dura, which was so infiltrated by the mass that it could not be separated from the mass. Half of the clivus was removed with a high speed drill. The mass was removed until adequate surgical decompression was achieved. Histology showed predominant lymphocytic infiltration. All cells were CD45+, some CD20+ and only a few CD3+. Yes No No No No No No No No No
262 Transphenoidal 0 A biopsy from the posterior pituitary was performed. Histology showed diffuse infiltration with lymphocytes. Yes No No No No No No No No No
263 not done 9 not done NR NR NR NR NR NR NR NR NR NR
264 Transphenoidal 0 At surgery, the inferior and posterior parts of the anterior pituitary and the inferior part of the posterior pituitary were firm in consistency, suggesting chronic inflammation. Several small pieces of tissue were excised from both lobes. Posterior lobe showed infiltration with lymphocytes and moderate fibrosis. Anterior lobe showed lymphocytes with scattered plasma cells and eosinophils. The acinar structure showed interstitial edema. IF using frozen sections revealed IgG and C3 deposits, mainly in the small vessels and often in the interstitial tissue. Yes Yes No Yes No Yes No No Yes Yes
265 Craniotomy (fronto-temporal) 0 Surgery revealed a grossly firm and fibrous mass arising from the infundibulum. Histology showed reactive gliosis with a chronic inflammatory infiltrate. Yes Yes No No No Yes No No No No
266 not done 9 not done NR NR NR NR NR NR NR NR NR NR
267 Transphenoidal 0 Surgery revealed a dark liquefied hematoma in the sella that was aspirated. The pituitary could then be seen and it was biopsied. Histology showed infiltration of lymphocytes and plasma cells with fibrosis in the anterior pituitary. Yes Yes No No No Yes No No No No
268 not done 9 not done NR NR NR NR NR NR NR NR NR NR
269 Transphenoidal 0 Histology of the biopsy specimens of the anterior pituitary showed effacement of its normal architecture by a dense inflammatory infiltrate that varied in composition. It was predominantly lymphocytic, but also contained a mixture of plasma cells, histiocytes, neutrophils and eosinophils. Ill-defined epitheliod granulomas containing multinucleated giant cells were present focally. Small calcify deposits and larger confluent foci of calcification were seen in some of the giant cells. Many pituicytes were vacuolated. Yes Yes No Yes Yes Yes Yes No No No
270 Transphenoidal 0 Surgery showed a remarkably solid tissue. Histologically, all type of pituitary cells were present but there was in the anterior hypophysis a considerable lymphocytic infiltration with fibrosis. Yes No No No No Yes No No No No
271 Transphenoidal 0 Histology of the biopsy showed anterior pituitary diffusely infiltrated with lymphocytes. No evidence of granuloma or giant cells. Yes No No No No No No No No No
272 not done 9 not done NR NR NR NR NR NR NR NR NR NR
273 not done 9 not done NR NR NR NR NR NR NR NR NR NR
274 Transphenoidal 0 Surgery revealed an enlarged, whitish and hard pituitary. Biopsy specimens showed infiltration with lymphocytes (CD8 positive, CD4 negative) in a portion of the pituitary stalk. The adenohypophysis was normal. No leukemic cells were observed in the sample. Yes No No No No Yes No No No No
275 Craniotomy (frontal) 0 The pituitary was white, enlarged and very tight and partially resected. Histology showed lymphocytic infiltration (predominantly T cells) and granuloma formation with giant cells and histiocytes. This was accompanied by small, focal, necrosis, cholesterin crystals, leukocytes, Schauman bodies, deposition of hemosiderin and macrophages. The translucent white mass hanging down from the sphenoid sinus was removed. Histology showed scar, bone fragment, mild lymphocytic infiltration, normal nasal mucosal epithelium. Yes No No No No Yes Yes Yes No No
276 Transphenoidal 2 Histology revealed lymphocytic hypophysitis Yes No No No No No No No No No
277 Transphenoidal 0 Hypophysectomy was performed and histology revealed granulomatous and lymphocytic hypophysitis Yes No No No No No No No No No
278 Transphenoidal 0 Hypophysectomy was performed and histology revealed granulomatous and lymphocytic hypophysitis Yes No No No No No No No No No
279 Transphenoidal 0 At surgery the lesion appeared sticky, yellowish and uniform. Histology revealed diffuse infiltration of the adenohypophysis by numerous lymphocytes, with occasional plasma cells and macrophages. No giant cells, granulomas or adenoma identified. Yes Yes No No No No No Yes No No
280 Transphenoidal 0 Histology showed lymphocytic hypophysitis Yes No No No No No No No No No
281 Craniotomy 0 A mass lesion arising from the infundibulum and adherent to the right optic nerve was detected and could not be removed completely. Histology showed anterior and posterior lobes of the pituitary heavily infiltrated by lymphocytes. Yes No No No No No No No No No
282 not done 9 not done NR NR NR NR NR NR NR NR NR NR
283 not done 9 Biopsy of the adenohypophysis was not done because of the spontaneous remission of the pituitary swelling and the advanced age of the patient. NR NR NR NR NR NR NR NR NR NR
284 Transphenoidal 0 Surgery showed a non-infectious, chronic inflammatory process. Histology analyzed several fragments of pituitary tissue that included adenohypophysis and fibrotic inflamed tissue. There was an infiltration of lymphocytes and plasma cells in the fibrotic tissue. Instead the adenohypophysis was intact and apparently spared by this inflammatory process. No granulomas, giant cells or vasculitic features. Stain for vasopressin identified immunoreactive components of the posterior lobe trapped within the fibrotic tissue. Yes Yes No No No Yes No No No No
285 Transphenoidal 1 A yellowish, firm mass was removed. Histology showed massive infiltration (multifocal or diffuse) of the anterior hypophysis with lymphocytes, plasma cells and macrophages. Only occasional granulocytes. A part of the specimen contained fibrosis. Immunohistochemistry showed reactivity for GH, ACTH, TSH, FSH, LH and alpha subunits, but not for PRL. Lymphocytes and plasma cells surrounded and invaded the acini; their surface villi made contact with the adjacent glandular cells. Yes Yes Yes No No No No Yes No No
286 Transphenoidal 0 Surgery revealed tissue of rather uniform consistency, not typical of adenoma. On one side, the postero-superior portion of the tissue was unusually white and less firm. When removed it left behind what appeared to be a normal gland. Histology of the biopsy showed multifocal inflammation, consisting mainly of lymphocytes mixed with a few plasma cells and macrophages. The adenohypophyseal cells retained their morphologic features and reacted with GH, PRL, ACT, TSH, FSH, LH and alpha-subunit antibodies. Yes Yes No No No No No Yes No No
287 Transphenoidal 0 The mass was partially resected. Histology showed pituitary tissue infiltrated with lymphocytes and plasma cells. Yes Yes No No No No No No No No
288 not done 9 The pituitary appeared grossly normal. Histology showed focal aggregates of mononuclear cells in the anterior lobe. In a few areas there were nodular aggregates of mature lymphocytes, but no germinal centers were observed. In most areas, the lymphocytes infiltrated diffusely into the parenchyma, with patchy fibrosis of the stroma and loss of parenchymal cells. Thyroid and parathyroids were normal. Adrenal cortexes were atrophic but without inflammation or signs of chronic adrenalitis. Yes No No No No Yes No No No No
289 not done 9 not done NR NR NR NR NR NR NR NR NR NR
290 not done 9 not done NR NR NR NR NR NR NR NR NR NR
291 Craniotomy (right pterional) 0 A grey, creamy encapsulated mass with some areas of firm tissue was found. Microscopically the bulk of the lesion consisted of fibrous tissue, with a heavy inflammatory infiltrate composed of lymphocytes and plasma cells. No granulomas or giant cells were found. Yes Yes No No No Yes No No No No
292 not done 9 not done NR NR NR NR NR NR NR NR NR NR
293 not done 9 not done NR NR NR NR NR NR NR NR NR NR
294 not done 9 not done NR NR NR NR NR NR NR NR NR NR
295 not done 9 not done NR NR NR NR NR NR NR NR NR NR
296 Transphenoidal 0 Biopsy showed lymphocytic hypophysitis Yes No No No No No No No No No
297 Transphenoidal 0 Biopsy showed lymphocytic hypophysitis Yes No No No No No No No No No
298 Transphenoidal 0 Biopsy showed lymphocytic hypophysitis Yes No No No No No No No No No
299 Transphenoidal 0 Biopsy showed lymphocytic hypophysitis Yes No No No No No No No No No
300 Transphenoidal 0 Biopsy showed lymphocytic infundibulo neuro-hypophysitis Yes No No No No No No No No No
301 Transphenoidal 0 Biopsy showed lymphocytic infundibulo neuro-hypophysitis Yes No No No No No No No No No
302 Transphenoidal 0 Biopsy showed lymphocytic infundibulo neuro-hypophysitis Yes No No No No No No No No No
303 not done 9 not done NR NR NR NR NR NR NR NR NR NR
304 not done 9 not done NR NR NR NR NR NR NR NR NR NR
305 not done 9 not done NR NR NR NR NR NR NR NR NR NR
306 not done 9 not done NR NR NR NR NR NR NR NR NR NR
307 Transphenoidal 0 A cystic cavity was seen, containing thick orange fluid. Its capsule was thin and difficult to remove. Lymphocytic hypophysitis. Cystic appearance. Yes No No No No No No No No No
308 Transphenoidal 0 The mass was very tough, unlike the adenoma. Histology showed lymphocytic hypophysitis. Yes No No No No Yes No No No No
309 Transphenoidal 0 A tough pituitary tissue was found in the sella, which also contained large quantities of purulent material. Histology showed lymphocytic hypophysitis. Yes No No No No No No No No No
310 Transphenoidal 0 A thick, creamy material evacuated upon incision of the lesion capsule, which was densely adherent to surrounding. Histology showed lymphocytic hypophysitis. Cystic appearance. Yes No No No No Yes No No No No
311 Transphenoidal 0 A yellowish, creamy material spontaneously evacuated. Cystic appearance. Yes No No No No No No No No No
312 not specified 0 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with lymphocytes, many plasma cells and a few eosinophils. Multinucleated giant cells and epitheliod histiocytes were absent. There was also severe fibrosis Yes Yes No Yes No No No No No No
313 not specified 0 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Mild fibrosis. Yes Yes No No No Yes No No No No
314 not specified 0 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Lymphoid follicles were present also with germinal centers. Mild fibrosis. Immunohistochemistry showed complete loss of ACTH-positive cells Yes Yes Yes No No Yes No No No No
315 not specified 0 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Lymphoid follicles present (no germinal centers). Mild fibrosis. Immunohistochemistry showed complete loss of ACTH-positive cells Yes Yes Yes No No Yes No No No No
316 not done 9 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Mild fibrosis. Immunohistochemistry showed complete loss of ACTH-positive cells. Yes Yes No No No Yes No No No No
317 not specified 0 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Severe fibrosis. Yes Yes No No No Yes No No No No
318 not specified 0 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Lymphoid follicles present (no germinal centers). Mild fibrosis. Immunohistochemistry showed complete loss of ACTH-positive cells Yes Yes Yes No No Yes No No No No
319 not specified 0 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Mild fibrosis. Yes Yes No No No Yes No No No No
320 not specified 0 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Severe fibrosis. Yes Yes No No No Yes No No No No
321 not specified 0 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Mild fibrosis. Yes Yes No No No Yes No No No No
322 not specified 0 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Lymphoid follicles present, also with germinal centers. Severe fibrosis. Yes Yes Yes No No Yes No No No No
323 not specified 0 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Mild fibrosis. Yes Yes No No No Yes No No No No
324 not specified 0 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Mild fibrosis. Yes Yes No No No Yes No No No No
325 not done 9 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Mild fibrosis. Immunohistochemistry showed complete loss of ACTH-positive cells. Yes Yes No No No Yes No No No No
326 not specified 0 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Mild fibrosis. Yes Yes No No No Yes No No No No
327 not specified 0 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Mild fibrosis. Yes Yes No No No Yes No No No No
328 not specified 0 Specimen obtained from the anterior pituitary only. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Mild fibrosis. Yes Yes No No No Yes No No No No
329 not specified 0 Specimen obtained from both the anterior and the posterior pituitary lobes. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Lymphoid follicles present, also with germinal centers. Severe fibrosis. In the posterior lobe there was mild lymphocytic infiltration. Yes Yes Yes No No Yes No No No No
330 not specified 0 Specimen obtained from both the anterior and the posterior pituitary lobes. Histology showed infiltration of the anterior hypophysis with both lymphocytes and plasma cells. Lymphoid follicles present, also with germinal centers. Mild fibrosis. In the posterior lobe there was severe lymphocytic infiltration. Yes Yes Yes No No Yes No No No No
331 Transphenoidal 0 Specimen obtained only from the pituitary stalk. Histology showed lymphocytic infiltration. Granulomas or multinucleated giant cells were not seen. Yes No No No No No No No No No
332 Transphenoidal 0 Specimen obtained only from the pituitary stalk. Histology showed lymphocytic infiltration. Granulomas or multinucleated giant cells were not seen. Yes No No No No No No No No No
333 Transphenoidal 0 Specimen obtained from both the anterior and the posterior hypophysis. The anterior hypophysis was histologically normal. The posterior hypophysis showed lymphocytic infiltration. Granulomas or multinucleated giant cells were not seen. Yes No No No No No No No No No
334 Craniotomy (right pterional) 0 A firm, pinkish grey mass, with gross enlargement of the distal optic nerves, chiasm and proximal tracts was encountered. A biopsy was taken from the inferior part of the expanded chiasm. Histological examination revealed extensive inflammation with lymphocyte and plasma cell infiltrate. Occasional neutrophils and foci of hemorrhage were present. There were no features of granuloma or neoplasia. Owing to concern about the accuracy of the biopsy, associated with worsening of the radiological picture (Figure 2), the procedure was repeated after 2 months. Once again, the histology showed inflammatory infiltration with lymphocytes and plasma cells. Treatment with dexamethasone was begun and hormone replacement therapy continued. Yes Yes No No Yes No No No No No
335 Transphenoidal 0 Surgery showed an extremely tough and fibrous mass, adherent to the dura. Frozen section revealed the possibility of lymphocytic hypophysitis and a subtotal excision of the mass within the pituitary fossa and suprasellar cisterns was performed. Histology showed extensive destruction of pituitary acini by a dense infiltrate of T lymphocytes, plasma cells and monocyte-macrophages. An occasional multinucleated giant cell was identified but no discrete granulomas were seen. Yes Yes No No No Yes No Yes No No
336 Transphenoidal 0 There was an area of brown discoloration consistent with the recent haemorrhage and an area about 5mm in diameter that appeared to be organized clot with a golden coloration. There was also tarry liquid consistent with old liquefied clot. The pituitary gland had a hard and rubbery component that was removed. In the anterior hypophysis there were large focal areas of fibrosis with a sparse chronic inflammatory infiltrate consisting of lymphocytes, plasma cells and eosinophils with loss of most of the adenohypophyseal cells in these areas. More severe chronic inflammation was seen in the intermediate lobe extending into the neurohypophysis. No granulomas or necrosis were seen. In immunohistochemical stains, the majority of lymphocytes were T cells (CD3 positive), with small numbers of B lymphocytes (CD20 positive). CD68 stain showed many macrophages in the areas of inflammation. The overall appearance was consistent with a lymphocytic hypophysitis, and the extensive areas of fibrosis within the adenohypophysis suggested a fairly chronic process. Yes Yes No Yes No Yes No No No No
337 Transphenoidal 0 A pituitary biopsy showed an inflammatory exudate consisting mainly of lymphocytes with small area of necrosis and fibrosis, there were no evidence of a histiocytic infiltrate or granuloma formation and no lymphoid follicles were present. Yes No No No No Yes No No No No
338 Transphenoidal 0 Surgery showed a small lesion, though and fibrous, which was removed completely. The gland macroscopically normal was left untouched. Histology showed in the anterior hypophysis diffuse infiltration with lymphocytes and plasma cells, with occasional formation of lymphoid follicles. There were also eosinophils, neutrophils and macrophages. The posterior hypophysis was normal. There were remaining islets of endocrine cells surrounded by interstitial fibrosis. The infiltrate was more prominent near the vessels. Immunohistochemistry showed positivity for LH, FHS< GH and PRL, whereas ACTH and TSH were negative. No granulomas or giant cells were seen. Yes Yes Yes Yes Yes Yes No Yes No No
339 not done 9 not done NR NR NR NR NR NR NR NR NR NR
340 not done 9 not done NR NR NR NR NR NR NR NR NR NR
341 Transphenoidal 0 Surgery showed a mass of increased consistency (unusual for adenomatous tissue), which was partially resected. Histology showed extensive mononuclear cell infiltration of the pituitary tissue with lymphocytes and plasma cells that formed lymphoid follicles with clear germinal centers. The neurohypophysis was morphologically normal. Yes Yes Yes No No No No No No No
342 not done 9 not done NR NR NR NR NR NR NR NR NR NR
343 not done 9 not done NR NR NR NR NR NR NR NR NR NR
344 not done 9 not done NR NR NR NR NR NR NR NR NR NR
345 Transphenoidal 0 Histology showed effacement of the anterior pituitary architecture, caused by extensive cellular infiltrate composed of lymphocytes, plasma cells and some neutrophils, with residual scattered endocrine cells. IHC showed positivity for L26 and LCA. Yes Yes No No Yes No No No No No
346 Transphenoidal 0 Surgeon removed the pituitary mass, which was tightly adherent to the dura. Histology revealed diffuse infiltration with lymphocytes and plasma cells. Yes Yes No No No No No No No No
347 Transphenoidal 0 Patient was on prednisolone and thyroxine for 5 months, but symptoms and MRI did not improve. Actually, vision deteriorated. Surgery revealed an ill-defined mass. Histology showed diffuse infiltration with lymphocytes, plasma cells and eosinophils. Also, dense collagenous fibrosis. Yes Yes No Yes No Yes No No No No
348 not done 9 not done NR NR NR NR NR NR NR NR NR NR
349 Transphenoidal 0 Diffuse, focally dense, infiltrate of lymphocytes, plasma cells and small number of eosinophils. No adenoma or granuloma. Immunohistochemistry showed that lymphocytes were both T and B. Yes Yes No Yes No No No No No No
350 Transphenoidal 0 Patient initially improved with methylprednisolone and vasopressin, but within 3 months imaging studies showed expansion of the pituitary mass to involve the basal hypothalamus and hypothyroidism and hypogonadism. Thus surgery was performed. This revealed a yellowish, extremely fibrotic mass, whose suprasellar portion could not be pulled down through the pituitary fossa because of its firm consistency. Histology revealed extensive collagenous fibrotic tissue infiltrated with lymphocytes and plasma cells. Yes Yes No No No Yes No No No No
351 Transphenoidal 0 Pituitary apoplexy was diagnosed and the patient underwent urgent resection of the mass. Frozen section showed anterior pituitary tissue infiltrated with T and B lymphocytes. Necrotic tissue was removed, leaving normal appearing pituitary gland. Yes No No No No No No No No No
352 Transphenoidal 0 Surgery revealed an extremely tough and fibrous mass, adherent to the dura. A complete excision of the mass within the enlarged pituitary fossa was performed as well as maximal subtotal excision of the tissue extending into the suprasellar cisterns. Histology showed destruction of anterior pituitary acini, dense fibrosis and infiltration with lymphocytes, plasma cells and histiocytes. Yes Yes No No No Yes Yes No No No
353 Transphenoidal 0 At surgery the pituitary gland appeared extremely tough and fibrous, with yellow discoloration. Frozen sections revealed a granulomatous process and a partial resection was performed. Histology showed extensive destruction of the anterior pituitary acini by a dense infiltrate of lymphocytes, plasma cells and histiocytes. In addition several non-necrotizing granulomas, composed of epitheliod histiocytes and occasional multinucleated giant cells were identified. Yes Yes No No No No Yes No No No
354 Transphenoidal 1 Surgery revealed an extremely thin sellar floor. The intrasellar tumor was firm and fibrous (not like a typical adenoma). Histology showed infiltrating lymphocytes and plasma cells. No definite pituitary parenchyma could be identified within the surgical specimen. Yes Yes No No No No No No No No
355 not done 9 NR NR NR NR NR NR NR NR NR NR
356 not done 9 not done NR NR NR NR NR NR NR NR NR NR
357 not done 9 not done NR NR NR NR NR NR NR NR NR NR
358 not done 9 not done NR NR NR NR NR NR NR NR NR NR
359 Transphenoidal 0 Patient underwent transphenoidal biopsy. The lesion that eroded the sellar floor was found fibrous and yellowish. Microscopic examination of the surgical specimen demonstrated granulation tissue, infiltration with slightly atypical lymphocytes (more B than T cells), some necrosis and fibrosis. Yes No No No No Yes No No No No
360 Transphenoidal 0 After replacement with thyroxine and prednisolone, the patient underwent transphenoidal surgery. Exploration revealed a yellowish, firm cyst wall with fibrous tissue and a cavity filled with creamy necrotic material. Normal anterior pituitary could barely be found in the periphery. Histology revealed necrosis with diffuse, dense infiltration of lymphocytes and plasmacells with interstitial reactive fibrosis, intercalated by eosinophils and normal pituitary glandular cells. Aggregates of foamy cells and macrophages were also noted. There was no evidence of neutrophils, giant cells, granulomatous or caseous necrosis, neoplastic cells, Rathke's pouch remnant, craniopharyngioma or micro-organisms. Yes Yes No Yes No Yes Yes Yes No No
361 Transphenoidal 0 Patient underwent transphenoidal surgery to remove part of the pituitary mass. The tissue was extremely fibrous and relatively avascular. Histopathology showed multiple fragments of sclerotic connective tissue with infiltrating lymphocytes, plasma cells and macrophages. There were remaining islands of endocrine cells that were hardly recognizable. Yes Yes No No No Yes No Yes No No
362 not done 9 NR NR NR NR NR NR NR NR NR NR
363 Transphenoidal 0 Patient was suspected of having lymphocytic hypophysitis and underwent surgery. Pathology showed lymphocytic hypophysitis. Yes NR NR NR NR NR NR NR NR NR
364 Transphenoidal 0 Pathology showed lymphocytic hypophysitis. Yes NR NR NR NR NR NR NR NR NR
365 Transphenoidal 0 The patient was suspected of having a pituitary adenoma. He underwent surgery. Histopathology showed lymphocytic hypophysitis. Yes NR NR NR NR NR NR NR NR NR
366 Transphenoidal 2 Patient was suspected of having pituitary adenoma. She underwent surgery. Histology showed lymphocytic hypophysitis. Yes NR NR NR NR NR NR NR NR NR
367 Transphenoidal 0 Patient was suspected of having a pituitary adenoma and underwent pituitary surgery. Histology showed lymphocytic hypophysitis and significant fibrosis. Yes NR NR NR NR Yes NR NR NR NR
368 Transphenoidal 0 The patient was suspected of having lymphocytic hypophysitis and underwent surgery. Histology confirmed the diagnostic suspicion. Yes NR NR NR NR NR NR NR NR NR
369 Transphenoidal 1 Patient was suspected of having lymphocytic hypophysitis and began medical therapy (prednisone, 5 mg/day). This therapy failed and the patient underwent surgery. Histology showed lymphocytic hypophysitis. Yes NR NR NR NR NR NR NR NR NR
370 Transphenoidal 0 The patient was suspected of having a pituitary adenoma and underwent surgery. Histology revealed lymphocytic hypophysitis and significant fibrosis. Yes NR NR NR NR Yes NR NR NR NR
371 Transphenoidal 0 The patient was suspected of having lymphocytic hypophysitis, she underwent surgery, and pathology confirmed the diagnostic suspicion. An associated Rathke's cleft cyst was described. Yes NR NR NR NR NR NR NR NR NR
372 0 Patient was suspected of having lymphocytic hypophysitis and underwent surgery. Pathology showed lymphocytic hypophysitis and significant fibrosis. Yes NR NR NR NR Yes NR NR NR NR
373 not done 9 NR NR NR NR NR NR NR NR NR NR
374 not done 9 NR NR NR NR NR NR NR NR NR NR
375 not done 9 NR NR NR NR NR NR NR NR NR NR
376 not done 9 NR NR NR NR NR NR NR NR NR NR
377 Transphenoidal 0 There was a craniopharyngioma. In addition, the anterior pituitary was invaded by numerous inflammatory cells, mainly lymphocytes. This invasion included the whole parenchyma within the obtained specimen. The inflammation of the glandular parenchyma was most pronounced in the vicinity of the transition zone between the pituitary parenchyma and the cystic wall of the craniopharyngioma. Yes No No No No No No No No No
378 Transphenoidal 0 There was a craniopharyngioma. In addition, the anterior pituitary was invaded by numerous inflammatory cells, mainly lymphocytes. This invasion included the whole parenchyma within the obtained specimen. The inflammation of the glandular parenchyma was most pronounced in the vicinity of the transition zone between the pituitary parenchyma and the cystic wall of the craniopharyngioma. Yes No No No No No No No No No
379 Transphenoidal 0 There was a craniopharyngioma. In addition, the anterior pituitary was invaded by numerous inflammatory cells, mainly lymphocytes. This invasion included the whole parenchyma within the obtained specimen. The inflammation of the glandular parenchyma was most pronounced in the vicinity of the transition zone between the pituitary parenchyma and the cystic wall of the craniopharyngioma. Yes No No No No No No No No No
380 Transphenoidal 0 A GH secreting chromophobe adenoma was found. In one area the tumor had an infiltrate of lymphocytes organized in a follicle. Yes Yes Yes No No No No No No No
381 Transphenoidal 0 Surgery showed a fossa almost completely occupied by a creamy cyst, which was excised. Histology showed fragments of rather distorted, compressed and atrophic anterior pituitary tissue, infiltrated by many plasma cells, moderate number of lymphocytes and scattered polymorphonuclear cells. There was considerable fibrosis; no germinal centers. One fragment had a central cavity lined by ciliated cuboidal epithelium, resembling that of respiratory cells. It was diagnosed as intrasellar Rathke's cleft cyst, with associated chronic hypophysitis Yes Yes No Yes Yes Yes No No No No
382 Transphenoidal 0 The pituitary appeared of normal color and texture. When incised, it released a white mucus. Grayish granulation tissue posterior to the cyst was removed. Histology showed a cyst wall lined with ciliated columnar epithelium and infiltrated by lymphocytes, neutrophils and foamy cells, and extensively replaced by granulation tissue. The neurohypophysis was infiltrated by lymphocytes, plasma cells and neutrophils, compatible with the prolonged inflammation with granulation. The adenohypophysis was also infiltrated by foreign body reaction, consisting of lymphocytes, plasma cells and foamy macrophages, but the endocrine cells were well preserved. Yes Yes No No Yes Yes No Yes No No
383 Transphenoidal 0 High-dose steroids were used for about 2 weeks with reduction in size of the intra- and suprasellar cystic masses. Surgery was performed 16 days after the steroid treatment and the intrasellar mass was excised. A slightly yellow cyst was observed behind the anterior lobe, and white creamy contents poured out when its wall was incised. The cyst wall was lined with ciliated columnar epithelium, focal areas of squamous metaplasia and occasional goblet cells. The pituitary mass abutting the cyst was heavily infiltrated by inflammatory cells, mainly lymphocytes and plasma cells. The histological diagnosis was Rathke's cleft cyst and adenohypophysitis. Yes Yes No No No No No No No No
384 Transphenoidal 0 Dense infiltration of mature lymphocytes in the anterior pituitary lobe Yes No No No No No No No No No
385 Transphenoidal 0 Histology showed germinoma, with associated lymphocytic infiltration, sometimes aggregating in nodules, with macrophages. Yes No Yes No No No No Yes No No
386 Transphenoidal 0 Histology showed germinoma, with associated lymphocytic infiltration, sometimes aggregating in nodules, with macrophages. Yes Yes No No No No No No No No
387 Transphenoidal 0 Histology showed germinoma, with associated lymphocytic infiltration, sometimes aggregating in nodules, with macrophages. Yes No No No No Yes No No No No
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25 Transphenoidal 0 Surgery showed sclerosis of the sella and a fibrotic, shrunken and yellow pituitary. The pituitary mass was biopsied. Histology showed a diffuse infiltration with lymphocytes and plasma cells. There was also one focus of necrosis: the central area contained neutrophils; the edges showed both inflammatory cells and giant cells, surrounded by epitheliod and inflammatory cells. There was marked fibrosis. Yes Yes No No Yes Yes No No No No
26 not done 9 The pituitary had normal size but had a firm consistency. Diffuse infiltration of the anterior hypophysis with lymphocytes and plasma cells. The thyroid was atrophic and infiltrated by lymphocytes and plasma cells, sometimes forming lymphoid follicles. The adrenal glands were atrophic in all three zones, but without inflammatory infiltrate. Yes Yes No No No No No No No No
27 not done 9 The adenohypophysis was edematous and fibrotic and had scanty parenchymal cells and numerous lymphocytes forming a few germinal centers. The thyroid was small (8 g) whitish and hard. It showed abundant lymphocytic infiltrates with frequent germinal centers. The adrenal were small and had almost total disappearance of the cortex, which massively invaded by lymphocytes. Yes Yes No No No Yes No No No No
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30 not done 9 The most striking histological lesion was found in the anterior hypophysis. There was extensive lymphocytic infiltration, mainly consisting of lymphocytes and some plasma cells. Most of the acini in the infiltrated areas were destroyed. The neurohypophysis was normal. The thyroid showed 2 foci of lymphocytic aggregates in 1 of 3 examined sections. Adrenals and parathyroid were normal. Yes Yes No No No No No No No No
31 Transphenoidal 0 Marked infiltration of the anterior hypophysis by T and B lymphocytes, scattered histiocytes and few eosinophils. Occasional germinal centers were seen. The architecture was intact, although fibrosis was noted. No ACTH staining cells were identified; the other cells (GH, PRL, TSH and gonadotropins) were normal. Yes Yes Yes Yes No No Yes No No No
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36 Transphenoidal 0 The mass was a firm, yellowish tissue, difficult to distinguish from the normal pituitary gland. About 2/3 were resected. Histology showed marked diffuse infiltration in the anterior hypophysis by mature lymphocytes with lymphoid follicles with germinal centers. A few plasma cells were also infiltrating. Moderate interstitial fibrosis Yes No Yes No No Yes No No No No
37 Transphenoidal 0 At surgery the pituitary appeared relatively normal on first inspection. Abnormal tissue could be seen posteriorly on the floor of the sella, easily distinguishable from the normal appearing gland. Portions of the pituitary contained an infiltrate of lymphocytes with an arrangement of cells in a vaguely nodular pattern. No granulomas or multinucleated histiocytes. Yes No No No No No No No No No
38 Transphenoidal 1 Surgery showed a yellowish and tough mass, not clearly demarcated from the normal pituitary. Two thirds of the mass were removed, and contained some cystic fluid. Histology showed marked lymphocytic infiltration, with many follicles, and some germinal centers. Some plasma cells and eosinophils were present. Acinar cells showed atrophy. Cystic appearance. Yes Yes Yes Yes No No No No No No
39 Craniotomy (frontal) 1 Surgery showed no meningioma and a mass in the sellar that was displacing the optic chiasm, of yellowish color and hard consistency (differently from a pituitary adenoma). The mass was biopsied. Frozen section indicated a possible lymphoma. About 70% of the mass was removed. Histology showed marked lymphocytic infiltration in the anterior hypophysis. The acinar cells showed vacuoles and in some areas epithelial metaplasia like the one seen in craniopharyngioma or epidermoid Yes No No No No Yes No No No No
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41 Transphenoidal 0 The pituitary appeared abnormal: it was yellow and exceptionally firm. No macroscopically normal pituitary tissue could be identified, and a near complete hypophysectomy was performed. Histology showed in the anterior hypophysis a diffuse infiltration of chronic inflammatory cells, mainly lymphocytes, some plasma cells and rare eosinophils, some germinal centers. Yes Yes Yes Yes No Yes No No No No
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43 Transphenoidal 0 Diffuse infiltration of the anterior pituitary with lymphocytes Yes No No No No No No No No No
44 Craniotomy (frontal) 1 Biopsy showed marked focal infiltration by lymphocytes and accompanying fibrosis. Some of the lymphocytes were noted to be in a follicular-type pattern. Yes No Yes No No Yes No No No No
45 Transphenoidal 0 Biopsy was performed 1 year after the first signs of hypopituitarism. Histology showed fragments of adenohypophyseal tissue infiltrated by numerous lymphocytes. Epitheliod and giant cells were absent. Yes No No No No No No No No No
46 Transphenoidal 1 Surgery revealed a mass strongly adherent to the walls of the sella; no normal pituitary tissue was seen. The mass was resected only incompletely. Histology showed a marked infiltration with lymphocytes and plasma cells, with also some eosinophils and few neutrophils, and some fibrosis. Lymphocytes frequently organize in follicles Yes Yes Yes Yes Yes Yes No No No No
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48 Transphenoidal 1 Abnormally firm and tenacious mass. Marked infiltration by lymphocytes that partially obscured the underlying tissue. Moderate fibrosis. No germinal centers in the tissue submitted. Hyperplasia of the lactotrophs, as would be expected in the post-partum. A small amount of neurohypophysis was present and did not have an infiltrate of lymphocytes. Yes No No No No Yes No No No No
49 Transphenoidal 0 A firm pale mass was present in the sella turcica. A limited decompression was carried out. The normal gland appeared displaced posteriorly. Massive infiltration of the anterior lobe by lymphocytes and plasma cells, with destruction of acinar cells and fibrosis. Yes Yes No No No Yes No No No No
50 Transphenoidal 0 A pale, avascular mass was found in the sella turcica. Diffuse lymphocytic infiltrate and destruction of normal pituitary Yes No No No No No No No No No
51 Transphenoidal 0 Upon opening of the dura, a hard, abnormal, dull-white pituitary tissue was observed. In the middle of the anterior lobe a grayish and fragile part was seen, which was biopsied. Histology showed in the anterior hypophysis a moderate lymphocytic infiltration in a fibrous stroma. There were granulomatous lesions but without multinucleated giant cells Yes No No No No Yes No No No No
52 Craniotomy (frontal) 0 A mass was encountered within the sella, extending up to the optic chiasm. It was grayish white and very firm, having to be biopsied by sharp dissection. Histology showed heavy infiltration of the anterior hypophysis with lymphocytes. Yes No No No No No No No No No
53 Transphenoidal 1 A very fibrous intrasellar lesion was resected. Yes No No No No Yes No No No No
54 Transphenoidal 1 Surgery showed an intrasellar inflammatory lesion. Histology showed preserved acini of anterior pituitary cells separated by large numbers of inflammatory cells with both lymphocytes and plasma cells. There was germinal center formation. The neurohypophysis was not involved. Yes Yes Yes No No No No No No No
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56 Transphenoidal 1 A large and extremely firm mass was found and excised because the frozen section suggested a adenoma. However, final histological exam revealed widespread lymphocytic infiltration with fibrosis Yes No No No No Yes No No No No
57 Transphenoidal 0 The pituitary was extremely firm and tough. A small piece was resected and showed dense fibrosis surrounding a lymphocytic infiltrate and scanty pockets of pituitary epithelium Yes No No No No Yes No No No No
58 Transphenoidal 0 Surgery was perfumed 2.5 months after her 2nd delivery. Frozen sections suggested a fibrosing adenoma. Final exam showed islands of pituitary cells surrounded by fibrous connective tissue and lymphocytes also forming follicles. Yes No Yes No No Yes No No No No
59 not done 9 Pituitary stalk appeared thickened. Histology showed severe chronic inflammatory cell infiltration of the infundibulum, stalk, and posterior lobe of the hypophysis. The anterior lobe was intact. The inflammatory cells consisted mainly of polyclonal B and T lymphocytes. A few plasma cells were also present. No inflammatory changes were evident in other parts of the brain or in the meninges. There was degeneration of the supraoptic and paraventricular nuclei, probably retrograde secondary to a lesion in the infundibulum and stalk. Yes Yes No No No No No No No No
60 Transphenoidal 0 Opening of the dura revealed a firm and dull white mass that, when incised appeared as creamy, soft tissue. No definitive diagnosis could be made on frozen sections. Pathology revealed an edematous pituitary, diffusely fibrotic and strikingly infiltrated by mature lymphocytes and plasma cells. Yes Yes No No No Yes No No Yes Yes
61 Transphenoidal 0 Opening of the dura revealed a firm and dull white mass, strongly adherent to the dura. When incised, the mass appeared as creamy and soft tissue. Frozen and final pathology showed striking infiltration of mature lymphocytes and macrophages, with thick fibrous tissue. Yes No No No No Yes No Yes No No
62 Transphenoidal 0 Surgery revealed an extremely fibrous mass adhering to the dura that was biopsied. Histology showed a mononuclear infiltrate mainly made of lymphocytes and plasma cells. Some glandular islets are preserved, other are atrophic and separated by fibrosis. Yes Yes No No No Yes No No No No
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64 Craniotomy (fronto-temporal) 0 Surgery showed a sellar mass of increased constancy, firmer than that of an adenoma, which was partially removed. Histology showed diffuse lymphocytic infiltration, with disruption of the hypophyseal architecture. Some normal adenohypophysis remaining. Yes No No No No No No No No No
65 Transphenoidal 1 Surgery showed a suprasellar mass with intense arachnoid fibrosis adhering to the optic chiasm. Histology showed pituitary tissue infiltrated by lymphocytes and plasma cells, with a smaller number of neutrophils and interspersing strands of fibrous tissue. Yes Yes No No Yes Yes No No No No
66 Transphenoidal 0 The sella turcica was filled by gray, tough, rubbery tissue. There was no definite cleavage plane or any normal-looking pituitary tissue, and resection was limited to a pituitary biopsy. Histology showed scattered infiltration of small mononuclear cells, among residual bands of pituitary cells. Yes No No No No Yes No No No No
67 Transphenoidal 0 A firm, yellow tissue was seen in the sella and partially removed. Histology showed an abnormal adenohypophysis with extensive fibrosis and scattered small nests of pituitary cells. There was infiltration of the tissue by numerous lymphocytes and plasma cells. Yes Yes No No No Yes No No No No
68 Transphenoidal 0 Surgery showed a reddish mass with signs of past hemorrhages. The mass was removed completely and the sella was filled with muscular tissue. Histology diffuse lymphocytic infiltration with some plasma cells and interstitial fibrosis, with some metaplasia of the acinar cells Yes Yes No No No Yes No No No No
69 Transphenoidal 0 Surgery, performed at the 25th week of pregnancy, showed a yellow, swollen and soft pituitary. A specimen of the pituitary tissue, of sufficient size to relieve pressure on the optic chiasm was obtained. Histology showed diffuse infiltration of the anterior hypophysis by mature lymphocytes and occasional plasma cells. No granuloma. Yes Yes No No No No No No No No
70 Transphenoidal 0 Large dull, white mass, extending 2 cm above the sella was subtotally removed. Infiltration of the anterior hypophysis by lymphocytes and plasma cells, with lymphoid follicles and fibrosis. Yes Yes Yes No No Yes No No No No
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72 Transphenoidal 0 A firm, dull, white mass was present in the sella and was entirely resected. Histology showed an anterior pituitary gland with residual nests of endocrine cells. There was diffuse infiltration of the entire pituitary gland by lymphocytes, plasma cells, eosinophils, with destruction of the parenchymal cells and fibrosis Yes Yes No Yes No Yes No No No No
73 Craniotomy (temporal) 0 Hard and encapsulated mass of 1.5 cm in diameter was observed between the optic nerves. Half of the mass was removed. Scanty pituitary cells left, infiltrated diffusely by lymphocytes and plasma cells. Neither granulomas nor giant cells. All of the resected specimen was histologically identified as anterior pituitary tissue. Yes Yes No No No No No No No No
74 Transphenoidal 0 On opening the dura a soft, fleshy, unusually yellow vascular tumor emerged spontaneously under pressure. The adenoma was composed of partly acidophils and partly chromophobe cells. The adjacent pituitary showed infiltration with lymphocytes, with few plasma cells and histiocytes. At junctional areas the mononuclear infiltrate extended into the adenoma as well. Yes Yes No No No No No No No No
75 Transphenoidal 0 A 8-mm yellowish mass in the anterior lobe was removed. Diffuse lymphocytic infiltration on a background of atrophic pituitary cells, fibrosis and edema Yes No No No No Yes No No Yes Yes
76 Transphenoidal 0 The sella was filled with an avascular, gray, fibrous tissue, most of which was removed. Extensive infiltration of the adenohypophysis by lymphocytes, plasma cells and histiocytes. Only small areas of secretory cells remained. A similar process involved the neurohypophysis. Yes Yes No No No Yes Yes No No No
77 Transphenoidal 0 The lesion consisted of a mixed inflammatory cell infiltrate, which included plasma cells, mature small lymphocytes, histiocytes and occasional eosinophils, as well as fibrosis (fibroblast + collagen). Yes Yes No Yes No Yes Yes No No No
78 Transphenoidal 0 Dura mater was found adherent to the anterior pituitary lobe. A firm, robbery and whitish mass was found in the center of the pituitary, not well demarcated from the normal. The mass was removed completely. Massive infiltration of plasma cells and lymphocytes, few neutrophils. Some granulomatous tissue found and also few remaining islands of secretory pituitary cells. Yes Yes No No Yes No No No No No
79 Craniotomy (fronto-temporal) 0 Surgery showed a grayish, firm mass arising from the pituitary fossa and compressing the optic chiasm. The mass could be partially removed with sharp dissection. Histology showed extensive infiltration of the anterior pituitary by chronic inflammatory cells, predominantly lymphocytes. A small number of plasma cells and some lymphoid follicles without germinal centers were also identified. Yes Yes Yes No No No No No No No
80 Craniotomy (frontal) 0 Surgery, performed during gestation, removed a rubbery, gray suprasellar mass, arising from the pituitary stalk. Dense fibrosis was associated with this mass. Histology showed nests of normal pituitary tissue densely infiltrated by lymphocytes and plasma cells, with a small number of neutrophils and moderate interstitial fibrosis. Immunohistochemistry showed the anterior pituitary endocrine cells, without apparent loss of any cell line. Yes Yes No No Yes Yes No No No No
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82 Craniotomy (right pterional) 0 Histology showed diffuse lymphocytic infiltration, with marked fibrosis Yes No No No No Yes No No No No
83 Transphenoidal 0 Surgery showed an abnormality within the anterior pituitary, which was biopsied. Histology showed infiltration of the anterior pituitary with lymphocytes. The posterior lobe was fibrotic Yes No No No No Yes No No No No
84 Transphenoidal 0 Patient began dexamethasone (2 mg/day). Visual fields improved. At the 34th week she went to the operating room for a cesarean section delivery and exploration of the sella turcica. Pathology showed lymphocytic infiltration of the pituitary, with disruption of the normal architecture. Yes No No No No No No No No No
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87 not done 9 The pituitary was slightly enlarged and appeared yellowish on cut surface. Microscopically there was an infiltrate mainly composed by plasma cells (some of which contained Russell bodies), but also lymphocytes, foamy macrophages, neutrophils and a few multinucleated giant cells. The infiltrate was present both in the anterior and the posterior hypophysis. In the anterior pituitary there were few remaining cords of acinar cells; whereas the posterior pituitary was completely destroyed. In the hypothalamus there was a focal, intense lympho-plasmacytic infiltrate in the meninges and around blood vessels. No other evidence of autoimmune disease was found at autopsy. Yes Yes No No Yes No No Yes No No
88 Transphenoidal 0 At surgery an abnormal yellowish, elastic hard tissue behind the normal pituitary was completely removed. Histology showed an extensive infiltration of the pituitary with reactive lymphocytes, plasma cells and some eosinophils. Yes Yes No Yes No No No No No No
89 Transphenoidal 0 Surgery was performed at the 30th week of pregnancy, choosing a partial debulking, as opposed to a total hypophysectomy, in the hope to preserve some normal pituitary function. Histology showed infiltration of the anterior hypophysis with lymphocytes and plasma cells, without germinal centers or granulomas. Fibrosis caused architectural disruption and decrease in cell population, but some remaining hypophyseal cells maintained an acinar arrangement. Yes Yes No No No Yes No No No No
90 Transphenoidal 0 Surgery showed a very enlarged fibrous gland, but no obvious tumor. Frozen sections revealed chronic inflammation on a background of a dense connective tissue. No further exploration was performed and the procedure was terminated. Yes Yes No No No No Yes No No No
91 Craniotomy (right pterional) 0 Histology of the biopsy showed infiltration of lymphocytes and plasma cells into the posterior lobe of the pituitary and the stalk. Yes Yes No No No No No No No No
92 Craniotomy (right pterional) 0 Histology of the biopsy showed infiltration of lymphocytes and plasma cells into the posterior lobe of the pituitary and the stalk. Yes Yes No No No No No No No No
93 Craniotomy (right pterional) 0 Histology of the biopsy showed infiltration of lymphocytes and plasma cells into the posterior lobe of the pituitary and the stalk. Yes Yes No No No No No No No No
94 Craniotomy (right pterional) 0 Surgery showed and enlarged, yellowish pituitary. Histology showed infiltration with lymphocytes, plasma cells, with some histiocytes and collagen fibers Yes Yes No No No Yes Yes No No No
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96 Transphenoidal 0 Pathology received several small fragments of tissue from the anterior hypophysis. Fibrosis and edema of the stroma with intense chronic inflammatory infiltrate formed by mature lymphocytes, plasma cells and a few histiocytes. Few remaining glandular structures. No granulomas or giant multinucleated cells were seen. Yes Yes No No No Yes Yes No No No
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98 Craniotomy (frontal) 0 A small biopsy was obtained from the pituitary stalk. Histology showed lymphocytic infiltration. Yes No No No No No No No No No
99 Transphenoidal 0 A biopsy was obtained from the neurohypophysis. Histology showed infiltration of inflammatory cells, mainly lymphocytes and plasma cells, with histiocytes and vascular endothelial cells. Yes Yes No No No No Yes No No No
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102 Transphenoidal 0 Surgery showed a mass in the sella that looked like an adenoma. Histology showed diffuse infiltration of mononuclear cells throughout the anterior hypophysis, mainly composed of lymphocytes. Also fibrosis, some neutrophils and eosinophils Yes Yes No Yes Yes Yes No No No No
103 Transphenoidal 0 Histology showed diffuse infiltration of the anterior pituitary by lymphocytes and plasma cells. Yes Yes No No No No No No No No
104 Transphenoidal 0 Histology showed diffuse infiltration of the anterior pituitary by lymphocytes Yes No No No No No No No No No
105 Transphenoidal 0 Histology showed diffuse infiltration of the anterior pituitary by lymphocytes Yes No No No No No No No No No
106 Transphenoidal 0 Incision of the pituitary released a creamy material. The surrounding tissue had a gritty, cobblestone appearance. The lesion extended also to the neurohypophysis, infundibular stalk and the median eminence of the hypothalamus. Histology showed necrosis surrounded by dense lympho-plasmacytic infiltrate, few eosinophils and considerable fibrosis. Normal posterior pituitary tissue was not seen. Yes Yes No Yes No Yes No No No No
107 Transphenoidal 0 Incision of the pituitary revealed necrotic material. Further exploration revealed only more necrotic tissue, involving the entire pituitary, including the neurohypophysis. Histology showed mostly necrotic material and areas of fibrosis. Small areas of glandular pituitary tissue were seen. Normal posterior pituitary tissue was not seen. Yes No No No No Yes No No No No
108 Transphenoidal 0 A biopsy was performed and indicated lymphocytic hypophysitis, without giant cell granuloma Yes No No No No No No No No No
109 Transphenoidal 0 Biopsy of the sellar lesion showed diffuse infiltration of mainly mature lymphocytes and some plasma cells. No evidence of sarcoidosis, tuberculosis, hisitocytosis X, plasmacytoma or giant cell granuloma. Yes Yes No No No No No No No No
110 Transphenoidal 0 The pituitary showed a granular, gray, firm, poorly demarcated mass, adherent to the dura and covered by a rim of normal pituitary tissue. Histology showed a diffuse mononuclear cell infiltrate, dominated by small lymphocytes and plasma cells, with some macrophages and eosinophils and fibrosis. No granulomas or multinucleated giant cells were seen. Yes Yes No Yes No Yes No Yes No No
111 Transphenoidal 0 Surgery showed a firm, dense, yellowish mass that, when incised, released a creamy fluid. The mass was resected and histology showed a diffuse mononuclear cell infiltrate, dominated by small lymphocytes and plasma cells, with some macrophages and eosinophils and fibrosis. No granulomas or multinucleated giant cells were seen. Yes Yes No Yes No Yes No Yes No No
112 Transphenoidal 0 The pituitary mass was partially resected. It appeared white-tan in color and soft (possible reflecting an active inflammatory process). Histology showed clusters of secretory cells surrounded by fibrosis and a predominantly mononuclear infiltrate, composed by lymphocytes, plasma cells, macrophages and many eosinophils. Yes Yes No Yes No Yes No Yes No No
113 Transphenoidal 0 A firm yellowish mass was excised; the normal pituitary gland could not be identified separately. Dense infiltration of the anterior pituitary by lymphocytes and plasma cells. A few islands of secretory cells remained. Yes Yes No No No No No No No No
114 Transphenoidal 0 The sella was filled with an avascular, dull-white, hard mass, which was resected piecemeal. When more than half of the intrasellar mass was removed, there was a soft white region that seemed to show normal residual pituitary. No definite diagnosis was made on frozen section. Pathology showed massive fibrosis accompanied by infiltrating lymphocytes, few islands of secretory cells left. No granulomas or giant cells were present. Yes No No No No Yes No No No No
115 Transphenoidal 0 A soft, whitish, encapsulated mass was found, with well-defined borders, which was completely removed. It extended to the sellar diaphragm, separated from it by a clear cleavage plane. Histology revealed abundant lymphocytic infiltration and extensive fibrosis surround the remaining areas of pituitary cells. No giant cells or granulomas. Neurohypophysis was not identified. Yes No No No No Yes No No No No
116 Transphenoidal 0 A large, firm pituitary was subtotally resected. Histology showed massive diffuse mononuclear cell infiltrate and fibrosis surrounding few remaining acinar cells. No granulomas or multinucleated cells. Yes Yes No No No Yes No No No No
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119 Transphenoidal 0 Surgery revealed a grayish, firm mass. There was no cleavage plane with the normal tissue and the mass was partially resected. Histology showed anterior hypophysis infiltrated by lymphocytes, plasma cells, and some eosinophils. There were lymphoid follicles with germinal centers. There was marked fibrosis. The remaining endocrine cells were in degeneration or necrotic. Yes Yes Yes Yes No Yes No No No No
120 not done 9 Pituitary was of normal size and brown. Histology showed peripheral necrosis and hemorrhage in the anterior lobe. The intermediate lobe showed lymphocytic infiltration and no fibrosis. The posterior lobe was normal. The thyroid (15 g) showed diffuse lymphocytic infiltration. The adrenal glands (1.2 and 1.7 g) showed marked cortical atrophy with calcium deposits. Ovaries were atrophic with absence of primary follicles. Yes No No No No No No No No No
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123 Transphenoidal 0 The patient was suspected of having craniopharyngioma and underwent surgery. The intrasellar mass was partially removed. A milky fluid was present. Histology showed a Rathke's cleft cyst, with a squamous epithelium (cytokeratin AE1/AE3 positive) lining the wall. There were numerous infiltrating lymphocytes (LCA-positive) in the adjacent stroma and pituitary cells, in both the anterior and posterior lobe. Yes No No No No Yes No No Yes Yes
124 Transphenoidal 0 A yellowish, soft and dull mass was removed. Normal pituitary could not be identified separately. Histology revealed an edematous, fibrotic pituitary strikingly infiltrated by mature lymphocytes and plasma cells. No caseous necrosis or epitheliod granulomas. Yes Yes No No No Yes No No No No
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126 Transphenoidal 0 Lymphocytic adenohypophysitis Yes No No No No No No No No No
127 Transphenoidal 0 Lymphocytic adenohypophysitis Yes No No No No No No No No No
128 Transphenoidal 0 Lymphocytic adenohypophysitis Yes No No No No No No No No No
129 Transphenoidal 0 Lymphocytic adenohypophysitis Yes No No No No No No No No No
130 Transphenoidal 0 The pituitary was enlarged, tough, fibrous and yellowish. Frozen-section biopsy indicated lymphocytic hypophysitis. Only a portion of the gland (the lower part) was removed to decompress the chiasm. Histology revealed diffuse infiltration of lymphocytes with a few plasma cells and eosinophils. No granulomas or multinucleated giant cells were found. Yes Yes No Yes No No No No No No
131 Transphenoidal 0 A solid, cream-colored mass was seen in the sella. Extensive lymphocytic infiltration with destruction of adjacent pituitary cells. Immunostaining for GH and PRL showed positivity outside the pituitary cells, thus indicating that the elevated serum levels of PRL and GH are likely caused by destruction of the lactotrophs and somatotrophs. Yes No No No No No No No No No
132 Transphenoidal 0 Surgery showed a tough, gray-white, relatively avascular mass, which was completely removed. Histology showed foci of lymphocytes around islands of pituitary cells. Occasional histiocytes were also present, but there were no plasma cells and no lymphoid follicle formation. Yes No No No No No Yes No No No
133 Transphenoidal 0 Anterior pituitary cells separated by edema and infiltrating lymphocytes. Occasional plasma cells. No lymphoid follicles, granulomas or histiocytic infiltrate Yes Yes No No No No No No Yes Yes
134 Transphenoidal 0 Diffuse infiltration of the anterior hypophysis by numerous lymphocytes and occasional plasma cells. No lymphoid follicles. In many areas cells of the anterior pituitary appeared in degeneration Yes Yes No No No No No No No No
136 Transphenoidal 1 The pituitary was diffusely enlarged, with no obvious demarcation between normal and abnormal tissue. The mass was firm and densely adherent to the medial walls of the cavernous sinus. Pathology revealed a distortion of the pituitary architecture with marked fibrosis and chronic inflammatory infiltrate. Several small lymphocytic aggregates but no germinal center formation. No multinucleated giant cells or granulomas. Many pituitary cells showed a peculiar oncocytic morphology characterized by intense eosinophilia of the cytoplasm. Ultra structural studies revealed numerous secretory granules and only a few mitochondria. Immunostaining for normal pituitary function was negative in the areas of lymphocytic infiltration. Yes No Yes No No Yes No No No No
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142 Transphenoidal 0 The pituitary mass appeared tough and fibrous. Histology showed an marked infiltration of the anterior hypophysis by lymphocytes and few plasma cells Yes Yes No No No No No No No No
143 Transphenoidal 0 Anterior pituitary infiltrated by lymphocytes with few plasma cells. Yes Yes No No No No No No No No
144 Transphenoidal 0 The sellar mass was removed piecemeal. Histology showed extensive infiltration of the adenohypophysis by lymphocytes and few plasma cells. No caseation, multinucleated giant cells or epitheliod cells were seen. Yes Yes No No No No No No No No
145 Transphenoidal 0 Lymphocytic hypophysitis Yes No No No No No No No No No
146 Transphenoidal 0 Lymphocytic hypophysitis Yes No No No No No No No No No
147 Transphenoidal 0 Lymphocytic hypophysitis Yes No No No No No No No No No
148 not done 9 Lymphocytic hypophysitis Yes No No No No No No No No No
149 not done 9 Lymphocytic Yes No No No No No No No No No
150 Transphenoidal 0 Lymphocytic Yes No No No No No No No No No
151 Transphenoidal 0 Lymphocytic hypophysitis Yes No No No No No No No No No
152 Transphenoidal 0 Lymphocytic hypophysitis Yes No No No No No No No No No
153 Transphenoidal 0 Lymphocytic hypophysitis Yes No No No No No No No No No
154 Transphenoidal 0 Lymphocytic hypophysitis Yes No No No No No No No No No
155 Transphenoidal 0 Lymphocytic hypophysitis Yes No No No No No No No No No
156 Transphenoidal 0 Histology of the resected fragments of the pituitary mass showed interstitial fibrosis and dense mononuclear cell infiltration. There was one prominent sclerotic area with small nests of residual adenohypophyseal cells, in which immunohistochemistry showed only ACTH expression. Yes Yes No No No Yes No No No No
157 Transphenoidal 1 Surgery, performed 5 months after delivery, revealed an abnormally elastic-hard, dull white mass. Upon incision, a yellow mucoidal fluid flowed out form the cystic cavity behind the dull white mass. Histology showed diffuse and extensive lymphocytic infiltration and fibrosis. In some areas lymphocytes aggregated in follicles. Only few nests of endocrine cells remained. The cyst was lined by ciliar columnar epithelium. The cyst was located in the periphery of the lesion, whereas lymphocytic infiltration and fibrosis were observed throughout. No adenoma, granuloma or multinucleated giant cell was present. Cystic appearance. Yes No No No No Yes No No No No
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161 Transphenoidal 0 A firm mass was found and a biopsy was taken. Histology showed extensive infiltration of the anterior hypophysis by lymphocytes, with some plasma cells and some lymphoid follicles with germinal centers. Yes Yes Yes No No No No No No No
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164 Transphenoidal 0 At surgery an avascular yellow mass was seen, clearly defined from the anteriorly situated residual adenohypophysis. The neurohypophysis could not be identified. Histology showed diffuse infiltration of lymphocytes and plasma cells, associated with fibrosis and edema. A few nests of residual adenohypophyseal cells were distributed sparsely in the background. Yes Yes No No No Yes No No Yes Yes
165 Transphenoidal 0 At surgery an avascular yellow hard elastic mass was found behind the residual adenohypophysis. Histology showed diffuse lymphocytic infiltration, destruction of the adenohypophyseal tissue and replacement by fibrotic tissue. Yes No No No No Yes No No No No
166 Transphenoidal 0 Partial hypophysectomy. Histology revealed epithelial cells surrounded by a dense infiltrate of lymphocytes and plasma cells, few eosinophils and widespread fibrosis Yes Yes No Yes No Yes No No No No
167 Craniotomy (right pterional) 0 The thickened infundibulum was biopsied. Histology revealed widespread lymphocytic infiltration with islets of fibrosis and small rests of normal infundibular tissue. Yes No No No No Yes No No No No
168 Transphenoidal 0 Histology showed a lympho-plasmacytic infiltrate. Yes Yes No No No No No No No No
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170 Transphenoidal 0 Mononuclear cell infiltrate, mainly lymphocytic. No multinucleated giant cells or granulomas. Yes No No No No No No No No No
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175 Transphenoidal 0 Histology showed extensive lymphocytic infiltration and interstitial fibrosis in the adenohypophysis. Yes No No No No Yes No No No No
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178 Transphenoidal 0 Biopsy showed infiltration of the hypophysis with lymphocytes, and also plasma cells, eosinophils and histiocytes. Germinal centers were seen and fibrosis. No granulomas Yes Yes Yes No No Yes Yes No No No
179 not done 9 The pituitary gland was atrophic, white-gray and hard. The anterior pituitary was replaced by fibrosis, edema and a moderate infiltrate with lymphocytes, plasma cells and few eosinophils. No germinal center, giant cells or granulomas were observed. The posterior pituitary was normal. Yes Yes No Yes No Yes No No Yes Yes
180 Craniotomy (right pterional) 0 Chronic inflammation with an inflammatory infiltrate composed predominantly of lymphocytes, along with some plasma cells and eosinophils. No histiocytes, granulomas or neoplastic cells were present. Yes Yes No Yes No No No No No No
181 Transphenoidal 0 A soft, yellowish mass was seen in the fossa and was completely removed. Histology showed lymphocytic hypophysitis Yes No No No No No No No No No
182 Transphenoidal 0 A firm, creamy-necrotic mass was seen in the sella and was completely removed. Histology showed lymphocytic hypophysitis. Yes No No No No No No No No No
183 Transphenoidal 0 A firm, greasy, whitish mass was seen in the sella and was subtotally removed. The normal pituitary gland was encountered in the upper sellar region. Histology showed in the anterior hypophysis lymphocytic hypophysitis with some plasma cells and fibrosis. Yes Yes No No No Yes No No No No
184 Transphenoidal 0 A firm, whitish mass was seen in the sella and completely removed. Histology showed lymphocytic hypophysitis healed stage Yes No No No No No No No No No
185 Transphenoidal 0 A creamy, yellowish, fibrotic mass was seen in the sella and completely removed. Normal-appearing pituitary tissue could be preserved beneath the diaphragm and in the lateral part of the sella. Histology showed in the anterior hypophysis lymphocytic hypophysitis, with some plasma cells and scattered polymorph nuclear cells. Yes Yes No Yes Yes No No No No No
186 Transphenoidal 0 A firm mass was seen in the sella and a biopsy was taken. Histology showed lymphocytic hypophysitis. Yes No No No No No No No No No
187 Transphenoidal 0 A firm, cartilaginous mass was seen in the sella and partially removed. Normal anterior pituitary tissue remained in the posterior part of the fossa. Histology showed mixed lymphocytic and granulomatous hypophysitis. No evidence of a systemic giant-cell disorder (such as tuberculosis or sarcoidosis). Yes No No No No No No No No No
188 Transphenoidal 0 On entering the pituitary fossa a capsule was identified and opened, rapidly releasing a gelatinous yellowish fluid. The consistency of the mass was quite firm. Histology showed dense infiltration of lymphocytes, plasma cells and a few eosinophils. Yes Yes No Yes No No No No No No
189 Transphenoidal 0 Surgery, performed after delivery, showed an enlarged, firm, pituitary gland with dense surrounding inflammatory tissue. Only a biopsy was performed because frozen sections indicated lymphocytic infiltration. Histology confirmed the diagnosis of lymphocytic hypophysitis. Yes No No No No No No No No No
190 Transphenoidal 0 Histology showed diffuse infiltration of lymphocytes and plasma cells, with destruction of the adenohypophysis, fibrosis and edema. No granulomas or giant cells. Yes Yes No No No Yes No No Yes Yes
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192 Transphenoidal 0 The mass was soft and easily removed but its borders were not so distinct from the surrounding normal hypophysis. Histology showed diffuse infiltration of mature lymphocytes and some plasma cells. No granulomas or multinucleated giant cells. Yes Yes No No No No No No No No
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195 Transphenoidal 0 Both the anterior and the posterior hypophysis were biopsied. Histology showed in the posterior lobe infiltration with lymphocytes and plasma cells. The anterior pituitary was normal. Yes Yes No No No No No No No No
196 Transphenoidal 0 Histology showed infiltration with lymphocytes and plasma cells and also necrosis. Yes Yes No No No No No Yes No No
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199 Craniotomy 0 Histology showed mononuclear inflammatory infiltrate Yes Yes No No No No No No No No
200 Transphenoidal 0 Surgery revealed a grey white, relatively avascular mass, which was completely removed. Histology showed diffuse infiltration of the anterior pituitary by numerous lymphocytes and a few macrophages. No granulomas were present. Lymphocytes infiltrated diffusely also the neurohypophysis. Yes No No No No No No Yes No No
201 Transphenoidal 0 A whitish-gray, elastic, hard mass was observed in the sella. Frozen section revealed lymphocytes. The mass was partially resected to decompress the optic chiasm. Histology revealed diffuse lymphocytic infiltration with stromal fibrosis and destruction of parenchymal cells. Yes No No No No Yes No No No No
202 Transphenoidal 0 The mass was cream-colored, very hard and poorly vascular. Histology showed fibrosis and infiltration with lymphocytes and plasma cells. Clusters of adenohypophyseal cells remained. Yes Yes No No No Yes No No No No
203 Transphenoidal 0 Surgery, preformed 3 weeks after delivery, showed a mass was cream-colored, relatively hard and difficult to aspirate. It was thought likely to be granulation tissue. The posterior central nonenhancing portion was necrotic. Histology showed lymphocytic adenohypophysitis, with lymphocytes, acidophilic cells, neutrophils and connective tissue. Yes No No No Yes Yes No No No No
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205 Transphenoidal 0 Chronic inflammation with fibrous changes, numerous lymphocytes and infiltration of plasma cells. No caseous necrosis or multinucleated giant cells. Yes Yes No No No Yes No No No No
206 Transphenoidal 0 Focal lymphocytic infiltrate in the adenohypophysis, with lymphoid follicle formation and attached portions of dense hyalinized fibrous tissue. Yes No Yes No No Yes No No No No
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210 Transphenoidal 0 The specimen contained anterior and also posterior lobe. Histology showed lymphocytic infiltration in the anterior lobe, with accompanying fibrosis. No infiltration in the posterior lobe, which showed an increased number of transformed glial cells Yes No No No No Yes No No No No
211 not done 9 Dense infiltration of lymphocytes in the anterior pituitary, with accompanying fibrosis. Lymphocytic infiltrates were also found in the intermediate lobe, spreading to the posterior lobe. Yes No No No No Yes No No No No
212 Transphenoidal 0 The specimen contained anterior and also posterior lobe. Histology showed lymphocytic infiltration, with accompanying fibrosis. Yes No No No No Yes No No No No
213 Transphenoidal 0 The specimen contained anterior lobe. Histology showed lymphocytic infiltration, with accompanying fibrosis. Yes No No No No Yes No No No No
214 Transphenoidal 0 The specimen contained anterior lobe. Histology showed lymphocytic infiltration, with accompanying fibrosis. Yes No No No No Yes No No No No
215 Transphenoidal 0 The specimen contained anterior lobe. Histology showed lymphocytic infiltration, with accompanying fibrosis. Yes No No No No Yes No No No No
216 Craniotomy (right pterional) 0 The pituitary stalk was thicker than normal, with a nodular mass in the mid part. The mass was hard and adherent to the surrounding tissue, but it could be dissected from the other structures of the pituitary stalk. The excised mass measured 3x3x4 mm. The surrounding arachnoidal structures of the pituitary stalk were normal. Histology showed diffuse infiltration with lymphocytes and also plasma cells. No granulomas, giant cells or neoplasm were seen. Yes Yes No No No Yes No No No No
217 Transphenoidal 0 She began replacement with glucocorticoids, thyroxine and desmopressin and then was operated. Upon entry to the sella, a fibrotically encapsulated cyst was encountered, which upon puncturing, exuded thick tan fluid. No definite pituitary gland was visualized but the infundibulum was recognized. Histology of the capsule showed that most of the normal pituitary parenchyma was replaced by fibrous tissue, lymphocytes, a few plasma cells and aggregates of foamy macrophages. No granuloma or giant cell. Yes Yes No No No Yes No Yes No No
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224 Transphenoidal 0 Hypophysectomy was performed. Histology showed lymphocytic hypophysitis. Yes No No No No No No No No No
225 Transphenoidal 0 A pituitary biopsy was performed. Histology showed lymphocytic hypophysitis. Yes No No No No No No No No No
226 Transphenoidal 0 Hypophysectomy was performed. Histology showed lymphocytic hypophysitis. Yes No No No No No No No No No
227 Transphenoidal 0 Hypophysectomy was performed. Histology showed lymphocytic hypophysitis. Yes No No No No No No No No No
228 Transphenoidal 0 Hypophysectomy was performed. Histology showed lymphocytic hypophysitis. Yes No No No No No No No No No
229 Transphenoidal 0 Hypophysectomy was performed. Histology showed lymphocytic hypophysitis. Yes No No No No No No No No No
230 Transphenoidal 0 Hypophysectomy was performed. Histology showed lymphocytic hypophysitis. Yes No No No No No No No No No
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233 Transphenoidal 0 Patient was operated because suspected of having a pituitary adenoma. The surgeon found hematoma. Histology showed infiltration with lymphocytes and plasma cells and sign of old hemorrage. Yes Yes No No No No No No No No
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235 Transphenoidal 0 Thickened sellar endosteum. Whitish, firm, sellar content. Histology showed lymphocytic hypophysitis. Yes No No No No No No No No No
236 Transphenoidal 0 Thickened sellar endosteum. Whitish, firm, sellar content. Histology showed lymphocytic hypophysitis. Yes No No No No No No No No No
237 Transphenoidal 0 Reddish inflammatory nodule of firm consistence, delineable from the normal pituitary. The nodule was completely removed. Yes No No No No Yes No No No No
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244 Transphenoidal 0 Histology showed lymphocytic hypophysitis with scattered islands of preserved anterior pituitary cells (visualized with chromogranin immunostaining). The lymphocytes population consisted of a mixture of T and B cells, the latter staining for both kappa and lambda light chains. A single germinal center was detected. Pituitary cells stained positive for GH, LH FSH and prolactin. No specimen stained positive for ACTH. Yes No Yes No No No No No No No
245 Transphenoidal 0 At surgery a soft, white tissue and a cystic cavity filled with creamy fluid were found and removed. No normal anterior pituitary was identified. Histology revealed a heavy infiltrate of T and B cells at the periphery of the lesion, and necrotic material with heavy macrophage infiltration, colliquative necrosis and cavitation in the center. No evidence of granulomas. Cystic appearance. Yes No No No No No No Yes No No
246 Transphenoidal 0 The interstitium of the anterior hypophysis was infiltrated diffusely by lymphocytes and fibrosis. Immunohistochemistry showed multiple GH and PRL reactive cells, occasional TSH cells and only a few ACTH cells. No epitheliod granulomas or caseous necrosis were seen. The lachrymal gland was biopsied and showed broadened interstitial septae, infiltrated by lymphocytes. In small areas the periductal infiltrate invaded the acini and the excretory ducts. A few excretory ducts showed signs of obstruction with granulocytes. Yes No No No No Yes No No No No
247 Transphenoidal 0 Behind the normal pituitary gland, a yellowish, elastic, firm cyst wall was exposed. On incising the cyst, a creamy necrotic material was obtained. Histology showed dense infiltration of lymphocytes, plasma cells and some eosinophils with remnants of normal fibrotic neurohypophysis tissue. The adenohypophysis also showed the striking lymphocytic infiltration, but less intense than that of the posterior lobe. Cystic appearance Yes Yes No Yes No Yes No No No No
248 Transphenoidal 0 Histology revealed diffuse infiltration of mainly mature lymphocytes. No evidence of sarcoidosis, tuberculosis, Langerhans' cell hisitocytosis, plasmacytoma or giant cell granuloma. Yes No No No No No No No No No
249 Transphenoidal 0 The resected specimen of the posterior pituitary revealed diffuse infiltration of mainly mature lymphocytes. Yes No No No No No No No No No
250 Transphenoidal 0 The sellar cavity was occupied by a grey/red tumor, of increased consistency, containing necrotic material and adhering to the cavernous sinus wall, from which could not be separated. The tumor was partially resected. Histology showed marked infiltration of the hypophysis, mainly composed of lymphocytes and plasma cells. Areas of necrosis were present. Yes Yes No No No Yes No No No No
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252 not done 9 Biopsy of the dura mater showed fibrosis with dense, hyalinized collagen tissue and patchy infiltration of small lymphocytes and plasma cells. No granulomas, giant cells or vasculitis. NR NR NR NR NR NR NR NR NR NR
253 Transphenoidal 0 At surgery no tumor was found macroscopically and only a biopsy was performed. Small clusters of epithelial cells were identified in the edematous and fibrous tissue. Epithelial cells were atrophic. There was infiltration with lymphocytes and plasma cells. Capillaries were dilated. Yes Yes No No No Yes No No Yes Yes
254 Transphenoidal 0 Histology of the biopsy specimen showed active hypophysitis in the anterior lobe, where the alveolar structure was densely infiltrated by lymphocytes. Shortly after surgery, the girl complained of severe headaches and bitemporal visual loss. Dexamethasone (18 mg/day) improved symptoms and reduced the size of the pituitary gland and the stalk. Several attempts of tapering Dex caused relapse of the infundibular lesion and exacerbations of visual defects, headaches and vomiting. A second transphenoidal surgery confirmed the diagnosis of active lymphocytic hypophysitis. Histology showed lymphocytic infiltrates and fibrosis. Yes No No No No Yes No No No No
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256 Transphenoidal 1 The sella was filled with an avascular, yellowish fibrous tissue, poorly demarcated from the normal gland. Most of the abnormal tissue was removed, leaving a portion of the anterior pituitary intact. Histology showed diffuse infiltration of the adenohypophysis with lymphocytes, some plasma cells, fibrosis and edema. Yes Yes No No No Yes No No Yes Yes
*NR = not recorded