PMC6311725_01
Magnetic resonance imaging (MRI) with gadolinium. A: T1-weighted showing diffuse thickening of the infundibulum (white arrow). B: T1-weighted sagittal showing absence of the posterior pituitary bright spot (blue arrow).
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fig1
A second MRI, one month later, revealed an abnormal thickening of the infundibulum with no evidence of the microadenoma (Figure 1).
Germinoma (left): large round germ cells (black arrows) within a background of lymphocytes (white arrow); H&E 200x, insert showing H&E 400x (right). A: C-kit (CD117) stains the membranes of neoplastic cells (400x). B: OCT-4 producing strong nuclear staining (400x). C: PLAP staining the membranes and the Golgi apparatus, blue arrows (400x). D: B-hCG staining isolated syncytiotrophoblastic cells (400x). B-hCG: human chorionic gonadotropin.
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fig2
The tissue was positive for an intrasellar pituitary germinoma, confirmed by positive human chorionic gonadotropin (hCG) staining, C-kit, and placental alkaline phosphatase (PLAP) (Figure 2).