PMC4976610_01
(A) Sagittal and (B) coronal postcontrast T1-weighted images shows rim enhancing hypointense T1 lesion in the sellar and suprasellar region with thickened enhancement of the pituitary stalk (black arrow) and additional meningeal enhancement along sellar floor an clival area. (C) Coronal T2-weighted image demonstrates compression of the optic chiasm (white arrow) by this lesion with hyperintense T2 change, representing optic neuropathy.
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A magnetic resonance imaging (MRI) of brain showed rim-enhancing lesion, hypointense on T1-weighted image, mixed hypo- and hyperintense on T2-weighted image, occupying the sellar region with suprasellar extension, measuring about 1.4 x 2.5 x 2.2 cm (Fig. 1).
Tissue biopsy from intrasellar region revealed necrotizing granulomatous inflammation (left) with multinucleated giant cells (white arrows) and infarction of the pituitary parenchyma (right) (H&E, 200x).
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Histopathology showed necrotizing granulomatous inflammation with adjacent infarcted normal pituitary tissue (Fig. 2).