case_images: PMC11018951_01
case_images: Preoperative dynamic contrast-enhanced MRI of the pituitary. (A-C) Case 1. The pituitary gland demonstrates heterogeneous enhancement, with bilateral areas of hypointense signal. Larger (about 11.3 x 5.5 mm) on right side (white solid arrows, (A, B); Smaller (about 3 x 3.5 mm) on left side (yellow solid arrow, A, C). A red solid arrow points to a non-enhancing area, representing a posterior pituitary cyst (C). (D-F) Case 2. A rounded hypo-enhanced signal about 5 mm in diameter is seen on the right side (white hollow arrow, in D), and a patchy area of reduced enhancement is observed on the left anterior side (yellow hollow arrows, in E, F). All A-F are post-contrast T1-weighted sequences. Coronal views in (A, D, E); Sagittal views in (B, C, F).
case_images: fendo-15-1373869-g001.jpg
case_images: PMC11018951_02_fendo-15-1373869-g001.jpg
case_images: f1
case_images: Dynamic contrast-enhanced pituitary MRI revealed a reduced enhancing area on the anterior left wing of the pituitary measuring approximately 5 x 3.5 mm, and another reduced enhancing area about 5mm in diameter on the right wing, suggesting the presence of double pituitary adenomas ( Figures 1D-F ).
case_images: Pathological results in Case 1. (A-C) Left-side adenoma: strongly positive staining for ACTH and positive for T-pit. (A) H&E, (B) ICH for ACTH, (C) ICH for T-pit. (D-F) Right-side adenoma: negative staining for ACTH and positive for SF-1. (D) H&E, (E) ICH for ACTH, (F) ICH for SF-1. Magnification x 200.
case_images: fendo-15-1373869-g002.jpg
case_images: PMC11018951_01_fendo-15-1373869-g002.jpg
case_images: f2
case_images: Immunohistochemical examination confirmed strong positive ACTH staining and the expression of T-pit transcription factor in the left-sided adenoma, while the right-sided adenoma showed negative staining for any pituitary hormones and expressed the SF-1 transcription factor ( Figure 2 ).
case_images: PMC11018951_02
case_images: Preoperative dynamic contrast-enhanced MRI of the pituitary. (A-C) Case 1. The pituitary gland demonstrates heterogeneous enhancement, with bilateral areas of hypointense signal. Larger (about 11.3 x 5.5 mm) on right side (white solid arrows, (A, B); Smaller (about 3 x 3.5 mm) on left side (yellow solid arrow, A, C). A red solid arrow points to a non-enhancing area, representing a posterior pituitary cyst (C). (D-F) Case 2. A rounded hypo-enhanced signal about 5 mm in diameter is seen on the right side (white hollow arrow, in D), and a patchy area of reduced enhancement is observed on the left anterior side (yellow hollow arrows, in E, F). All A-F are post-contrast T1-weighted sequences. Coronal views in (A, D, E); Sagittal views in (B, C, F).
case_images: fendo-15-1373869-g001.jpg
case_images: PMC11018951_02_fendo-15-1373869-g001.jpg
case_images: f1
case_images: Dynamic contrast-enhanced pituitary MRI revealed a reduced enhancing area on the anterior left wing of the pituitary measuring approximately 5 x 3.5 mm, and another reduced enhancing area about 5mm in diameter on the right wing, suggesting the presence of double pituitary adenomas ( Figures 1D-F ).
case_images: Pathological results in Case 2. (A-C) Left-side adenoma: positive staining for ACTH and T-pit. (A) H&E, (B) ICH for ACTH, (C) ICH for T-pit. (D-F) Right-side adenoma: positive staining for ACTH and T-pit. (D) H&E, (E) ICH for ACTH, (F) ICH for T-pit. Magnification x 200.
case_images: fendo-15-1373869-g003.jpg
case_images: PMC11018951_02_fendo-15-1373869-g003.jpg
case_images: f3
case_images: The immunohistochemical results confirmed that both pituitary adenomas stained positive for ACTH and expressed the T-pit transcription factor ( Figure 3 ).