http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
A Surgical Case of Lymphocytic Hypophysitis with Progressive Visual Worsening
Shin, Hee-Sup,Park, Bong-Jin,Lim, Young-Jin The Korean Neurosurgical Society 2007 Journal of Korean neurosurgical society Vol.42 No.3
Lymphocytic hypophysitis is a clinically rare disease, and it has been known to be an autoimmune disease which mainly affects pregnant women at the end of gestation or right after delivery. The authors experienced a case of lymphocytic hypophysitis in a 29-year-old pregnant woman with rapid progressing visual disturbance. Sella MRI showed a mass-like lesion of hypophysis and hypertrophy of pituitary stalk with evidences of hypopituitarism. Cesarean section was done and then TSA was performed. The pathologic diagnosis was lymphocytic hypophysitis. After TSA, visual acuity was improved and visual field defect was recovered. She was given thyroid hormone replacement therapy because of transient partial hypopituitarism for 6 months after surgery. One must consider the probability of lymphocytic hypophysitis, if there are alteration of visual acuity and visual field defect which aggravate rapidly during pregnancy due to mass effect, decreased serum hormonal levels shown in hypopituitarism and sella MRI findings of hypertrophy of pituitary stalk and enlargement of pituitary gland.
고현선 ( Hyun Sun Ko ),이희중 ( Hee Joong Lee ),이근호 ( Keun Ho Lee ),장은덕 ( Eun Deok Chang ),강석구 ( Seok Gu Kang ),신종철 ( Jong Chul Shin ),박태철 ( Tai Churl Park ) 대한주산의학회 2005 Perinatology Vol.16 No.4
Lymphocytic hypophysitis, a rare inflammatory disorder in the pituitary gland that is often associated with pregnancy, is caused by autoimmune destruction of the pituitary gland evidenced by diffuse lymphocytic infiltration in the pituitary gland. We report a case of lymphocytic hypophysitis in a 38-year-old woman presenting with aggravating headache and sudden visual loss during pregnancy, which was misdiagnosed as pituitary adenoma before neurosurgery. Magnetic resonance imaging, with enhancement, showed an expanding 2.5×2.0×1.7 cm sized sellar mass. The patient underwent transsphenoidal surgery with a preoperative diagnosis of pituitary macroadenoma. A histological examination revealed diffuse lymphocytes and fibrosis of adenohypophysis with atrophy, which are characteristic of lymphocytic hypophysitis. We report a case of lymphocytic hypophysitis occurred during pregnancy with a brief review of literatures.
김상우,권정도,박도훈,Sang Woo Kim,Jung Do Kwon,Do Hoon Park 대한안과학회 2006 대한안과학회지 Vol.47 No.7
Purpose: To report a rare case of lymphocytic hypophysitis in a 31-year-old woman who presented with gradually progressive bilateral visual loss during the third trimester of pregnancy. Methods: Ophthalmologic examination revealed best corrected visual acuity of 0.02 OD and counting fingers at 20 cm OS. Pupil examination revealed no relative afferent pupillary defect in either eye and intraocular pressure was normal in both eyes. A visual field test revealed nearly total visual defect sparing superotemporal area OD and total defect OS. An MRI of the head was performed. Results: At the time of transsphenoidal surgery following the patient`s delivery, a frozen biopsy of the lesion revealed diffuse lymphocytic infilteration and fibrosis of the pituitary gland consistent with the diagnosis of lymphocytic hypophysitis. Postoperatively the patient was treated for hypopituitarism. At 5 weeks postoperative, her best corrected visual acuity was 1.0 OU, and visual field defects resolved in both eyes. On follow-up by telephone for postoperative 7 months, the patient remained visually asymptomatic. Conclusions: The clinical presentation of lymphocytic hypophysitis may mimic pituitary adenoma, lymphoma, germinoma, and histiocytosis. The diagnosis should be suspected in any pregnant or postpartum patient with an intrasellar or suprasellar mass.
증례 : 임파구성 뇌하수체염으로 오인된 시상상부 배아종 1예
김길선 ( Guil Sun Kim ),박신애 ( Shin Ae Park ),황희정 ( Hui Jeong Hwang ),이종율 ( Jong Yul Lee ),고승현 ( Seung Hyun Ko ),안유배 ( Yu Bai Ahn ),송기호 ( Ki Ho Song ) 대한내과학회 2007 대한내과학회지 Vol.73 No.2
본 증례에서는 임파구성 뇌하수체염으로 의심되었던 뇌하수체 종괴가 경과관찰 및 스테로이드 치료에도 반응이 없어 이후 시상상부 배아종으로 확진된 증례이다. 임파구성 뇌하수체염은 시야결손의 비교적 드문 원인질환이기도 하나, 조직검사를 시행한 부위에 따라 조직학적으로 다른 종양과 감별이 어려운 경우도 있다. 본 증례는 이러한 관점에서 매우 희귀한 경우이며 이에 대한 올바른 진단과 병인, 향후 치료에 대해 생각할 수 있는 계기를 삼고자 본 증례를 보고하는 바이다. We report here on a case of a 22-year-old girl with a suprasellar mass that was originally diagnosed as lymphocytic hypophysitis, but it eventually turned out to be a germinoma. She initially underwent partial tumor removal and the tissue diagnosis was suggestive of lymphocytic hypophysitis. 46 months later, she presented with a lateral visual field defect and decreased visual acuity of her right eye. The serum and cerebrospinal β-hCG and α-fetoprotein levels were measured. The β-hCG level was elevated in both, whereas the α-fetoprotein level was detectable in neither. The serum anti-pituitary antibody-1 level was negative. She was reoperated and the permanent section biopsies were compatible with pure germinoma. There was no evidence of meningeal metastasis on her whole spine MRI. She was treated with chemotherapy. (Korean J Med 73:210-215, 2007)
보존적 치료로 임상 경과의 호전을 보인 요붕증을 동반한 림프구성 누두신경뇌하수체염 1예
이지명,황병희,최현숙,이성수,김지영,김성래,이광우,손호영,강성구,유순집,박상미 대한내분비학회 2008 Endocrinology and metabolism Vol.23 No.2
Idiopathic central diabetes insipidus is most likely to occur in young patients who have a clinical history of autoimmune disease. The presentation of clinical findings such as central diabetes insipidus and pituitary stalk thickening on sellar magnetic resonance imaging (MRI) in a young women would strongly suggest lymphocytic hypophysitis, which is a rare inflammatory process involving the pituitary stalk and the pituitary gland, yet this disease can sometimes regress.We describe here a young woman with lymphocytic hypophysitis. She suffered from an abrupt onset of central diabetes insipidus. Sellar MRI showed thickening of pituitary stalk and loss of high signal of normal neurohypophysis on T1-weighted image. Combind pituitary stimuation test showed a blunted response of GH. To avoid the potential detrimental complications of invasive diagnostic procedures for testing the pituitary function in a fertile unmarried young woman, we chose close clinical and radiologic follow-up in the proper clinical context. The requirement for DDAVP was slightly decreased over time and the MR imaging obtained serially for 6 months revealed spontaneous partial regression of the pituitary lesion. (J Korean Endocr Soc 23:142~147, 2008)
Lymphocytic Hypophysitis in a Patient with Testiculal Feminization Syndrome
Cho, Tack-Geun,Kwon, Jeong-Taik,Nam, Teak-Kyun,Suk, Jong-Sik The Korean Neurosurgical Society 2007 Journal of Korean neurosurgical society Vol.41 No.1
Lymphocytic hypophysitis is a rare inflammatory disease of the pituitary gland that is one of the cause of hypopituitarism. The majority of cases occur in women during the peripartum period, and it is rare in men. Testicular feminization syndrome is a genetic disorder presenting a 46XY karyotype, but a normal female phenotype. We report a case of lymphocytic hypophysitis in a 23-year-old woman with testicular feminization syndrome.
박만철 ( Man Chul Park ),윤문희 ( Moon Hee Youn ),이원기 ( Won Ki Lee ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.6
Lymphocytic hypophysitis is a rare but important cause of pituitary hypofunction which predominantly affects young women in the peripartum period. It is believed to be an autoimmune disorder with an association with other autoimmune disorders. Clinically, it presents most frequently with symptoms and signs attributable to pituitary hypofunction, headache, visual disturbance and amenorrhea. It is difficult to distinguish lympnocytic from a pituitary adenoma on preoperative imaging. So the diagnosis must be confirmed pathologically. The frozen section must be done for saving the risk of permanent hypopituitarism that would have attended a more radical debulking procedure. If lymphocytic hypophysitis is confirmed by frozen section, extensive surgical debuling may not be necessary. A 31-year-old woman presented during the third trimester of pregnancy in July of 2003 with headache, vomiting and gradually progressive bilateral visual loss. There was a large 8 shaped homogeneous sellar mass on MR images before delivery. The subtotal excision of tumor was done via transsphenoidal surgery three weeks after cesarean delivery. Visual field testing revealed marked resolution of her visual field defects in both eyes. We report a case of lymphocytic hypophysitis occurred in the third trimester of pregnancy with a brief review of literatured.
분만 후 심한 저혈당이 동반된 림프구성 뇌하수체염 1예의 경과 관찰
손장명,고승현,안유배,주강,이정록,양성은,송기호,손호영,전정수 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.3
저자들은 출산 후 발생한 심한 저혈당을 주소로 내원한 31세 여자 환자에서 뇌 자기공명영상검사에서 뇌하수체종괴가 관찰되고 복합 뇌하수체 기능검사 결과전반적인 뇌하수체 기능저하증의 소견을 보여 림프구성 뇌하수체염을 진단하고, 호르몬 보충요법만으로 경과를 관찰하여 호전된 예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Lymphocytic hypophysitis, an inflammatory disease of the pituitary gland that is often associated with pregnancy, is caused by autoimmune destruction of the pituitary gland evidenced by diffuse inflammatory cell infiltration of the pituitary gland and some kinds of detectable autoantibodies. We report a case of lymphocytic hypophysitis in a 31-year-old woman presenting with severe hypoglycemia and hyponatremia after delivery. Hormonal study revealed panhypopituitarism and magnetic resonance imaging with enhancement showed the bulging contour of the right side pituitary gland with an ill-defined mass-like lesion and nodular thickening of the stalk The patient's symptoms and biochemical data improved greatly with replacement of L-thyroxine and glucocorticoid. Partial recovery of panhypopituitarism was also seen. The follow-up tests revealed dramatic resolution of the pituitary lesion (J Kor SOC Endocrinol 1 8 : 3 25 -33 1, 2003).