Pituitary tuberculosis mimicking idiopathic granulomatous hypophysitis.
An unusual case of tubercular granulomatous hypophysitis is reported. A sellar mass diagnosed as pituitary adenoma in MRI, showed non-caseating granulomas, glandular destruction and fibrosis in histology. Stain for acid-fast bacilli (AFB) were negative and the case was misdiagnosed as Idiopathic Granulomatous hypophysitis. The patient came back 2 weeks after trans-sphenoidal endoscopic resection with meningitis. CSF showed mixed pleocytosis. PCR for Mycobacterium tuberculosis was positive. The case is reported to highlight the need to maintain a high degree of suspicion for tuberculosis in any form of granulomatous hypophysitis, with or without caseous necrosis, in regions endemic for tuberculosis to prevent subsequent complications.
Husain
Nuzhat
N
Department of Pathology, King George's Medical University, Lucknow, 226003, India. drnuzhathusain@hotmail.com
Husain
Mazhar
M
Rao
Pallavi
P
D000236:Adenoma / Q000175:diagnosis; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D003951:Diagnostic Errors; D005260:Female; D006099:Granuloma / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D010900:Pituitary Diseases / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D010902:Pituitary Gland / Q000473:pathology*; D010911:Pituitary Neoplasms / Q000175:diagnosis; D016862:Tuberculoma, Intracranial / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D014390:Tuberculosis, Meningeal / Q000188:drug therapy / Q000209:etiology*