case_images: PMC2910471_01
case_images: Pre-operative axial (a), coronal (b) and sagittal (c) Gadolinium-enhanced T1-w MR images showing the cystic lesion in the sella.
case_images: JO2010-195323.001.jpg
case_images: PMC2910471_01_JO2010-195323.001.jpg
case_images: fig1
case_images: It extended into the suprasellar cistern determining a minimal displacement of the optic chiasm (Figure 1).
case_images: (a) Intraoperative image showing the pus-like fluid drained at dural opening. (b) Intraoperative frozen section showing round and polygonal cells, with a diffuse growth pattern; no evidence of inflammatory cells or foamy histiocytes.
case_images: JO2010-195323.002.jpg
case_images: PMC2910471_01_JO2010-195323.002.jpg
case_images: fig2
case_images: Surgical exploration via the endoscopic transsphenoidal route revealed a cystic lesion containing pus-like fluid, which was drained after dural opening (Figure 2(a)). The intraoperative histopathological examination indicated a pituitary adenoma (Figure 2(b)). 
case_images: Hematoxylin-Eosin stain. Fragments of intact, normal pituitary gland infiltrated by foamy histiocytes.
case_images: JO2010-195323.003.jpg
case_images: PMC2910471_01_JO2010-195323.003.jpg
case_images: fig3
case_images: The postoperative full histopathological work-up revealed an inflammatory infiltrate of numerous foamy histiocytes, multinucleated giant cells containing cholesterol clefts, and lymphocytes infiltrating between residual nests of normal pituicytes (Figure 3).
case_images: Postoperative immunohistochemical stain. Chronic inflammatory cells reaction with collections of foamy histiocytes (IHC: CD68, fast red).
case_images: JO2010-195323.004.jpg
case_images: PMC2910471_01_JO2010-195323.004.jpg
case_images: fig4
case_images: On immunohistochemical sections, the infiltrating foamy cells, were strongly positive for CD68, a macrophage marker (Figure 4).
case_images: Postoperative coronal (a) and sagittal (b) T1-w MR images, showing no pathological changes in the sellar region.
case_images: JO2010-195323.005.jpg
case_images: PMC2910471_01_JO2010-195323.005.jpg
case_images: fig5
case_images: A postoperative Gadolinium-enhanced head MRI at 8 months showed a normal pituitary gland with no pathological changes (Figure 5). 