Korean J Med.  2001 Aug;61(2):168-172.

A case of lymphocytic infundibuloneurohypophysitis presenting as central diabetes insipidus and nodular mass on neurohypophysis

Affiliations
  • 1Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. cgyks@hanmail.net
  • 2Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, College of Medicine, Gyeonsang National University, Chinju, Korea.

Abstract

Lymphocytic infundibuloneurohypophysitis was known as a cause of idiopathic central diabetes insipidus. Until recent time, it is characterized into two groups. One has thickening of the pitutitary stalk, enlargement of the neurohypophysis and loss of hyperintense signal of the normal neurohypophysis, the other has only loss of hyperintense signal but not morphological change. A 51-year-old man presented with a one month history of polydipsia and polyuria. The interpretation of water deprivation test was compatible with complete central diabetes insipidus. Endocrinologic examination of the adenohypophysis hormones and its triple stimulation test were normal apart from thyroid stimulating hormone (TSH), which showed low response despite thyrotropin releasing hormone (TRH). Sellar MRI scan disclosed an loss of hyperintense singnal of normal neurohypophysis and about 10 mm-sized nodular mass lesion on neurohypophysis. However, thickness of the pituitary stalk was normal. Pathologic examination demonstrated diffuse infiltration of lymphocytes and plasma cells. No adenomas, menigitis, sarcoidosis or granulomas were present. We supposed that this case was an atypical type of lymphocytic infundibuloneurohypophysitis, which did not belong to any other part of two groups described above.

Keyword

Lymphocyte; Pituitary gland, Posterior; Diabetes insipidus, Neurogenic; MRI scan

MeSH Terms

Adenoma
Diabetes Insipidus, Neurogenic*
Granuloma
Humans
Lymphocytes
Magnetic Resonance Imaging
Middle Aged
Pituitary Gland
Pituitary Gland, Anterior
Pituitary Gland, Posterior*
Plasma Cells
Polydipsia
Polyuria
Sarcoidosis
Thyrotropin
Thyrotropin-Releasing Hormone
Water Deprivation
Thyrotropin
Thyrotropin-Releasing Hormone
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