Document Detail

"Exterritorial" lymphocytic hypophysitis within an ovarian teratoma during pregnancy: a possible sentinel lesion?
MedLine Citation:
PMID:  18950959     Owner:  NLM     Status:  MEDLINE    
Pituitary tissue is rarely to be found among the constituents of ovarian teratomas (dermoid cysts). In some exceptional cases, however, such ectopic pituitary anlagen may even give rise to secondary organ-specific pathologies. Akin to those of the pituitary in its natural location, these tend to be adenomas. We describe a unique example of lymphocytic hypophysitis incidentally encountered in a mature left ovarian teratoma from a 30-year-old woman in the 19th week of pregnancy. Amidst various fully differentiated derivatives of all three embryonic layers, the cyst wall also included a miniature replica of the anterior pituitary lobe 0.5 cm in diameter. While a full set of adenohypophyseal hormone-producing cell types could be identified, there was characteristic pregnancy-related hyperplasia of lactotrophs. This was further overlaid by prominent mononuclear inflammation, including infiltration by T lymphocytes, follicular aggregates of B cells, and attendant destruction of parenchyma. There was no significant inflammatory reaction elsewhere. Discounting the non-standard location, the ensemble of the clinical setting and histology were felt to be indistinguishable from the classical paradigm of lymphocytic hypophysitis complicating pregnancy. To date, lymphocytic thyroiditis is the sole form of organ-specific inflammatory process within an ovarian teratoma on record. By analogy, we hypothesize that this ectopic manifestation of immune-mediated inflammation of pituitary parenchyma may possibly be read as a preclinical sentinel lesion of lymphocytic hypophysitis.
Heide Schreiber-Facklam; Anna M Wagner; Kirsten Staehler; Daniel Surbek; Andreas Kappeler; Arthur Zimmermann; Istvan Vajtai
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-10-23
Journal Detail:
Title:  Pathology, research and practice     Volume:  205     ISSN:  0344-0338     ISO Abbreviation:  Pathol. Res. Pract.     Publication Date:  2009  
Date Detail:
Created Date:  2008-12-16     Completed Date:  2009-03-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806109     Medline TA:  Pathol Res Pract     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  51-6     Citation Subset:  IM    
Department of Clinical Histopathology, Institute of Pathology, University of Bern, Murtenstrasse 31, P.O. Box 62, 3010 Bern, Switzerland.
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MeSH Terms
Choristoma / pathology*,  surgery
Dermoid Cyst / pathology*,  surgery
Inflammation / pathology
Lymphocytes / pathology*
Ovarian Neoplasms / pathology*,  surgery
Pituitary Diseases / pathology*,  surgery
Pituitary Gland, Anterior*
Pregnancy Complications, Neoplastic / pathology*,  surgery
Teratoma / pathology*,  surgery

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