@article{3081138,
    title = "Isolated pituitary granuloma by atypical Mycobacterium in a
nonimmunosuppressed woman",
    author = "Florakis, D and Kontogeorgos, G and Anapliotou, M and Mazarakis, N and and Richter, E and Bruck, W and Piaditis, G",
    journal = "Clinical Endocrinology",
    year = "2002",
    volume = "56",
    number = "1",
    pages = "123-126",
    publisher = "Wiley-Blackwell Publishing Ltd",
    issn = "0300-0664, 1365-2265",
    doi = "10.1046/j.1365-2265.2002.01362.x",
    abstract = "A 32-year-old woman presented with a 10-day history of fever
(38.0degreesC), headaches, nausea, vomiting and a 6-month history of
diabetes insipidus and amenorrhoea. Two months previously she had
undergone a surgical drilling of the right mastoid area because of
mastoiditis, Endocrine investigation showed elevated serum prolactin
levels, secondary adrenal and gonadal failure and a normal thyroid
function. Cranial MRI scan revealed a contrast enhancing intrasellar
mass (similar to2 cm) of heterogeneous appearance with suprasellar
extension and thickening of the pituitary stalk. Lumbar puncture was
suggestive of aseptic meningitis. The Ziehl-Neelsen stain of
cerebrospinal fluid (CSF) and the tuberculin skin test were both
negative. The pituitary mass was removed with a transsphenoidal
approach. Histological examination demonstrated destruction of the
adenohypophysis by epithelioid granulomas with partial caseous necrosis
and microabscess formation, suggestive of a mycobacterial infection. A
polymerase chain reaction analysis performed on paraffin-embedded tissue
was positive for mycobacterial DNA, According to the individual 16S
sequence, it was identified as Mycobacterium malmoense, an atypical
nontuberculous mycobacterium (NTM). In conclusion, this is the first
case of an isolated pituitary granuloma caused by an NTM infection in a
nonimmunosuppressed patient."
}