CT of pituitary abscess.

A 25-year-old woman from India, 3 months postpartum, presented with continued lactation (prolact in 108 ng / ml) and a left temporal field defect. The patient had no history of or current evidence for infection, sinusitis, or meningitis. High-resolution CT was performed with contrast enhancement only. Because of the thin sect ion technique (1 .5 mm slices), coronal and sagittal reformations were available for analysis. The sella was moderately and symmetrically enlarged with the dorsum sellae intact. A "sphere" of contrast enhancement was detectable in the sella and suprasellar cistern . This ring was uniformly thin around a large low-density center (fig. 1). Within the sella, the ring of enhancement was difficult to differentiate from adjacent bone and enhancing cavernous sinus. The scan showed no abnormalities in the subarachnoid space indicative of meningitis. The paranasal sinuses were normal. Surgery was performed via a transsphenoidal approach; Staphylococcus was cultured from a pituitary abscess. At surgery only dura was encountered at the floor of the sella; no defin ite separate abscess capsule cou ld be dist inguished. Microscopic examinat ion of removed tissue d isclosed no tumor cells, on ly inflammatory cells and normal pituitary .