PMC10070337_01
Preoperative visual field assessment. (a) Left eye; (b) Right eye.
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F1
Formal ophthalmological examination revealed markedly constricted visual fields [Figure 1].
Preoperative magnetic resonance imaging. (a) Gadolinium-enhanced T1 coronal image showing enlarged pituitary gland displaying homogeneous enhancement (arrow); (b) gadolinium-enhanced T1 sagittal image; (c) T2-weighted coronal image showing upward displacement of the optic chiasm (arrowhead).
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F2
Magnetic resonance imaging (MRI) revealed an enlarged pituitary gland measuring 11.5 mm (CC) x 7 mm (AP) x 13 mm (transverse) [Figure 2].
(a) Pituitary hyperplasia (inset) various cell types present include eosinophilic, basophilic, and chromophoric cells. (b) Reticulin histochemistry - acinar structures outlined in black (Gomori's modified reticulin stain) - expanded acini contrast with normally sized examples in the lower half of the photomicrograph. (c and d) Pit-1 immunostaining (Sigma polyclonal) - brown signal labels cell nuclei of Pit-lineage with more infrequent cell nuclei labelled with anti-SF-1 (ThermoFisher clone N1665).
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F3
Further examination of the paraffin embedded tissue [Figure 3] identified pituitary tissue with preserved acinar architecture; acini containing admixed eosinophilic, basophilic, and chromophoric cells in varying proportions.
Postoperative magnetic resonance imaging. (a) Gadolinium-enhanced T1 coronal image revealing a central biopsy cavity (arrowhead) with surrounding pituitary tissue (arrow); (b) T2-weighted coronal image revealing reduction in degree of optic chiasmal compression.
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F4
Postoperative MRI revealed adequate decompression of the optic chiasm with residual normal pituitary gland [Figure 4].
Postoperative visual field examination (a) Left eye; (b) Right eye.
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F5
This was confirmed with formal ophthalmological testing [Figure 5].