Granulomatous hypophysitis.

364 CMYK hyperintense bright spot signal of the normal neurohypophysis, thickening of pituitary stalk and enlargement of neurohypophysis in cases where it is involved. A review of literature revealed only two case reports of this association with lymphocytic hypophysitis (both in female patients), and one case with granulomatous hypophysitis (intrasellar tuberculoma). Surgical intervention is required to establish the diagnosis and to reduce the size of the lesion to relieve the mass effect on adjacent structures. Prasad et al. proposed a management paradigm for suspected cases of lymphocytic hypophysitis and advocated a trans sphenoidal stereotactic biopsy to achieve a tissue diagnosis, which might avoid the need for an open exploration of the sella. The present case highlights the fact that apoplectic changes may complicate the course of inflammatory pituitary lesions, thus calling for a greater vigil and clinical judgment in management of these patients.