Computed tomography of the brain in patients with serum prolactin levels over 200 ng/ml.
We reviewed the computed tomographic (CT) findings of the sella turcica in 26 patients with a serum prolactin level of over 200 ng/ml. The interval between the dates of CT examination and checking of the serum prolactin level were within 2 months. There were 24 nonpregnant women with a mean age of 30 years and 2 men with a mean age of 28.5 years. None of them were taking medication known to cause an elevation in serum prolactin levels. Surgery was performed on 8 patients with chromophobe adenomas of the pituitary gland: 6 of them were proven to have prolactin-secreting tumors (prolactinomas) after performing a special stain, and the remaining 2 patients, clinically diagnosed as prolactinomas, showed extremely high serum prolactin levels (3,200 and 2,251 ng/ml, respectively). CT studies showed that the height of the pituitary gland in the coronal sections were more than 7 mm in 15 cases (58%) and more than 10 mm in 13 cases (50%); focal bulging of the diaphragma sellae in 16 cases (62%); erosion of the sellar floor in 20 cases (77%); deviation of the pituitary stalk in 19 cases (73%); and abnormal attenuation or enhancement of the pituitary gland in 18 cases (69%). Three patients (12%) showed no evidence of any abnormal CT finding despite a hyperprolactinemic state of over 200 ng/ml. Six histologically proven cases (23%) of prolactinomas and chromophobe adenomas showed radiologic evidence of cavernous sinus invasion. We conclude that patients with a serum prolactin level higher than 200 ng/ml generally show significant changes in the sella turcica in CT.
Chang
Y C
YC
Department of Radiology, Medical College and Hospital, National Taiwan University, Taipei, R.O.C.
Liu
H M
HM
Huang
K M
KM
Wang
T C
TC
Hsu
J C
JC
D000238:Adenoma, Chromophobe / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging; D011388:Prolactin / Q000097:blood*; D015175:Prolactinoma / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
D011388:Prolactin