PMC5079424_01
Transverse (a,b,c,d) and Sagittal (e,f) MRI images of the brain showing a large spheroideal mass in the sellar/parasellar region. The mass was characterized by isointense signal on T1-weighted images (a) and high signal on T2-weighted (b and e) and FLAIR (c) sequences. A circular lesion hypointense on T1-weighted (f) and hyperintense on T2-weighted images was observed in the dorso-lateral aspect of the mass. After contrast medium administration, the mass showed a heterogeneous intense enhancement. Note the ventricular asimmetry and the moderate deviation of the falx cerebri on the transverse images of the brain (a,b,c,d).
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F1
MRI revealed a moderate ventricular asymmetry, discrete left deviation of the falx cerebri, enlargement of the third ventricle and the presence of a large (18x20x15 mm) spheroidal mass in the sellar/parasellar region characterized by isointense on T1 weighted images (Fig. 1a,f) and increased signal on T2 weighted (Fig. 1b,e) and FLAIR (Fig. 1c). In the dorso-lateral portion of the mass, a circular lesion (6 mm diameter) characterized by intense and homogeneous signal hyperintensity on T2 weighted images was detected (Fig. 1e). After gadolinium-based contrast medium was administered intravenously (0.2 ml/kg), the mass showed heterogeneous intense enhancement (Fig. 1d).
Histological findings of the pituitary gland. (a) Histological examination showed a wide, infiltrative, unencapsulated, not well circumscribed, densely cellular neoplasm composed of polygonal cells arranged in nests and packets supported by a fine fibrovascular stroma with numerous small hyperemic vessels. (b) Details of the neoplastic cells with severe anisokaryosis, anisocytosis and karyomegaly.
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F2
Pituitary gland was completely effaced by a wide, infiltrative, unencapsulated, not well circumscribed, densely cellular neoplasm composed of polygonal cells arranged in nests and packets supported by a fine fibrovascular stroma with numerous small hyperemic vessels (Fig. 2a). N/C ratio, moderate amount of eosinophilic cytoplasm occasionally finely granular (Fig. 2a,b). Nuclei were round to ovalar, with one or two magenta nucleoli. Severe anisokaryosis, anisocytosis and karyomegaly were evident with rare binucleated cells (Fig. 2b).