Imaging findings of immunoglobin G4-related hypophysitis:A case report  

作　　者：Kun Lv Xin Cao Dao-Ying Geng Jun Zhang 

机构地区：[1]Department of Radiology,Huashan Hospital,Fudan University,Shanghai 200040,China [2]Institute of Functional and Molecular Medical Imaging,Fudan University,Shanghai 200040,China [3]Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Research,Science and Technology Commission of Shanghai Municipality,Shanghai 200003,China [4]Institute of Intelligent Imaging Phenomics,International Human Phenome Institutes(Shanghai),Shanghai 200433,China

出　　处：《World Journal of Clinical Cases》2022年第26期9440-9446,共7页世界临床病例杂志

基　　金：Supported by National Key R&D Program of China,No.2019YFC0120602;Clinical Research Plan of SHDC,No.SHDC2020CR3020A;Research Startup Fund of Huashan Hospital,Fudan University,No.2021QD035;Shanghai Municipal Commission of Science and Technology,No.22S31905300;Greater Bay Area Institute of Precision Medicine(Guangzhou),No.KCH2310094。

摘　　要：BACKGROUND Immunoglobin G4(IgG4)-related hypophysitis(IgG4-RH)is a rare form of IgG4-related disease(IgG4-RD),which often manifests as a single organ disease and is easily misdiagnosed as a pituitary tumor clinically and by imaging.There are few reports of imaging findings of IgG4-RH.Therefore,we describe a case of IgG4-RH,which mimicked a pituitary macroadenoma,that was detected by computed tomography(CT)and magnetic resonance imaging(MRI),and review the previous literature in order to further the understanding of IgG4-RH.CASE SUMMARY A 47-year-old man presented with a history of blurred vision for more than 2 mo,without other symptoms.A preoperative unenhanced CT scan revealed a slightly hyperdense mass in the sellar region measuring 2.5 cm×2.3 cm×1.8 cm,with a CT value of 45 HU.T1-weighted imaging(T1WI)and T2-weighted imaging showed iso-hypointensity,and gadolinium contrast-enhanced T1WI showed obvious homogeneous enhancement.The MRI revealed involvement of the pituitary gland and stalk.Preoperative laboratory tests revealed abnormal pituitary hormone levels,including an increased prolactin level,and decreased levels of insulin-like growth factor,dehydroepiandrosterone,and testosterone.The lesion was surgically resected.Postoperative histopathological examination of a tissue sample and an elevated serum IgG4 level confirmed the diagnosis of IgG4-RH.The patient was treated with cortisone acetate postoperatively and made a good recovery without developing any neurological deficit.CONCLUSION An elevated serum IgG4 concentration is the main clue for diagnosis of IgG4-RD.Imaging combined with laboratory testing is useful for preoperative diagnosis of IgG4-RH.

关 键 词：Immunoglobin G4-related disease PITUITARY MACROADENOMA Inflammation HYPOPHYSITIS Case report 

分 类 号：R593.2[医药卫生—内科学] R584[医药卫生—临床医学]