A case of lymphocytic hypophysitis presenting as a pituitary macroadenoma.

The results of her basal pituitary function tests taken at that time are tabulated below ( table 1 ). These results suggest adrenocorticotropic hormone (ACTH), thyroid stimulating hormone (TSH) and prolactin deficiencies. A repeat MRI scan of her pituitary demonstrated a normal pituitary gland with no optic chiasmal compression, nor evidence of pituitary haemorrhage. In view of the spontaneous resolution of her visual field defect and pituitary macroadenoma, together with the ACTH and TSH deficiencies, a clinical diagnosis of lymphocytic hypophysitis was made. The patient was treated with hydrocortisone and thyroxine. On further follow-up, she remains well with no headaches or visual disturbances, a normal menstrual cycle and improved energy levels.