4.2 Article

Typing of inflammatory lesions of the pituitary

Journal

PITUITARY
Volume 25, Issue 1, Pages 131-142

Publisher

SPRINGER
DOI: 10.1007/s11102-021-01180-1

Keywords

Pituitary; Hypophysitis; Pathology; Classification

Funding

  1. Novartis Pharma GmbH (Nuremberg, Germany)
  2. Novo Nordisk Pharma GmbH (Mainz, Germany)
  3. Pfizer Pharma GmbH (Berlin, Germany)
  4. Ipsen Pharma GmbH (Ettlingen, Germany)

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Inflammatory pituitary lesions account for 1.8% of all specimens from the German Pituitary Tumor Registry, with women being significantly more affected. Secondary inflammation is more common than primary inflammation, with Rathke's cleft cysts being the most common cause.
Inflammatory pituitary lesions account for 1.8% of all specimens from the German Pituitary Tumor Registry. They occure in 0.5% of the autoptical specimens and in 2.2% of the surgical cases. Women are significantly more often affected than men and are often younger when first diagnosed. In general, primary and secondary inflammation can be distinguished, with secondary types occurring more frequently (75.1%) than idiopathic inflammatory lesions (15.4%). In primary inflammation, the lymphocytic type is more common (88.5%) than the granulomatous type of hypophysitis (11.5%). The most common causes of secondary inflammation are Rathke's cleft cysts (48.6%), followed by tumors (17.4%) such as the craniopharyngioma (9.1%), adenoma (5.5%) or germinoma (2.0%). More causes are tumor-like lesions (7.1%) such as xanthogranuloma (3.5%) or Langerhans histiocytosis (3.5%), abscesses (5.5%), generalized infections (5.1%), spreaded inflammations (4.7%) and previous surgeries (4.0%). In 1.6% of all specimens the reason for the inflammation remains unclear. The described classification of hypophysitis is important for specific treatment planning after surgery.

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