淋巴细胞性垂体炎和肉芽肿性垂体炎的诊断和治疗

目的分析淋巴细胞性垂体炎和肉芽肿性垂体炎的诊断和治疗。方法回顾性总结病理证实为淋巴细胞性垂体炎7例和肉芽肿性垂体炎2例。平均年龄28．2岁，平均病程5．5个月。临床表现为头痛、尿崩症、垂体功能低下、视功能障碍和动眼神经麻痹。MRI示蝶鞍区肿物，呈等或低信号，增强后均匀强化。结果经蝶窦手术全切除6例，部分切除3例。随诊1—6年，术前头痛、尿崩症、视功能障碍明显改善，但垂体功能低下部分改善。结论垂体炎术前较难明确诊断，对出现症状者，应及时手术探查，术中尽量切除病变组织，术后补充激素。

Diagnosis and management of lymphocytic and granulomatous hypophysitis

Objective To discuss the diagnosis and management of Lymphocytic and granulomatous hypophysitis.Methods In this retrospective study,we reviewed the clinic data,endocrinological and radiological examation,operative finding and effect with 7 cases of lymphocytic hypophysitis and 2 cases of granulomatous hypophysitis.The mean age was 28.2 years old,and mean history was 5.5 months.The clinical signs were headache,diabetes inspidus,hypopituitarism,visual defect by turns.Magnetic resonance imaging(MRI) revealed sellar lesion with homo-or hypoindense at T1 and pituitary stalk enlargement.Results Transsphenoidal surgery were performed on all the patients.Total removal were achievel in 6 cases and partial removal in 3 caes.Follow-up were 1-6 years,most of patients had remission of headache,diabetes inspidus,and visual defect,but only some patients had improvement in hypopituitarism.Conclusions It was difficult to make correct diagnosis of lymphocytic and granulomatous hypophysitis.Transsphenoidal surgery should be performed to patients with clinical signs at once and lesion should be removed totally to increase the operation effect.