PMC4100599_01
(a) A T1-weighted magnetic resonance imaging (MRI) of the sellar region showing a diffusely enlarged pituitary gland measuring 1.6 (W)x1.1 (H) cm with lateral extensions encasing both cavernous sinuses bilaterally and mild compression of the optic chiasm. (b) A T1-weighted MRI of the sellar region after contrast showing heterogeneous enhancement of the enlarged pituitary gland along with the thickened lateral walls of both cavernous sinuses.
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fig1
The differential diagnosis was inflammatory or infiltrative disorders of the pituitary gland (Fig. 1).
(a) Haematoxylin and eosin stain (20x original magnification). Sheets of monomorphic neoplastic lymphoid cells with pleomorphic nuclei, coarse chromatin and little cytoplasm. (b) Ki-67 stain (4x original magnification). Malignant lymphoid cells stained heavily with a Ki-67 index of 100%.
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fig2
The histological diagnosis was malignant B-cell lymphoma (Fig. 2a). Further immunohistochemical staining indicated that the malignant lymphoid cells were positive for CD20 and CD10 and negative for BCL2; Ki-67 was 100% (Fig. 2b).