Indian Journal of Radiology Indian Journal of Radiology  

   Login   | Users online: 342

Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size     

 

NEURORADIOLOGY Table of Contents   
Year : 2006  |  Volume : 16  |  Issue : 2  |  Page : 179-180
Ectopic neurohypophysis - a case report


Department of Radiology, Yashoda Superspeciality hospital, Malakpet, Hyderabad-500036, Andhra Pradesh, India

Click here for correspondence address and email
 

Keywords: Adenohypophysis, Neurohypophysis, Short stature

How to cite this article:
Kiranmayi A L, Nunna S, Chamarthi S K, Mukarrab A M. Ectopic neurohypophysis - a case report. Indian J Radiol Imaging 2006;16:179-80

How to cite this URL:
Kiranmayi A L, Nunna S, Chamarthi S K, Mukarrab A M. Ectopic neurohypophysis - a case report. Indian J Radiol Imaging [serial online] 2006 [cited 2019 Nov 17];16:179-80. Available from: http://www.ijri.org/text.asp?2006/16/2/179/29082

   Introduction Top


Ectopic Neurohypophysis is an anomaly of the Pituitary gland and is found in 43% of patients presenting with short stature due to Growth hormone deficiency[1].MRI is the modality of choice in diagnosing this condition. We present a case of short stature due to growth hormone deficiency with pituitary anomaly.


   Case report Top


A 14 year old boy presented with short stature. No contributory antenatal, familial or past medical history was present. He is the second child of non-consanguinous marriage. Clinical history revealed short stature (height below third percentile), bone age less than the chronological age, abnormal 24 hr Growth hormone secretory pattern and peak Growth hormone levels less than 10ng/ml during provocative stimulation tests. Radiograph of both hands showed bone age corresponding to less than 11 yrs.MR imaging was done on a 0.3T permanent magnet Airis II.Imaging was done in the three orthogonal planes using T1W SE, T2W FSE, PD and FLAIR sequences.3D T1W volume sag/axial/coronal recon images were obtained.

The T1W sagittal images showed hyperintense focal area in the Infundibulum.The normal hyperintense signal of neurohypophysis was not seen in posterior sella. Anterior pituitary gland was small in size (3x3mm) with normal signal intensity and pituitary stalk was not seen [Figure - 1],[Figure - 2].


   Discussion Top


The appearance of Pituitary gland on MR images is best evaluated in the Sagittal and Coronal images. In adults on T1W images the Adenohypophysis has intermediate signal and shows homogeneous bright signal following contrast enhancement. The Neurohypophysis has characteristically bright signal due to the presence of phospholipids in the neurosecretory granule membrane. In the neonatal period the Pituitary gland is hyperintense without any difference between the Adenohypophysis and Neurohypophysis [2].

Posterior Pituitary Ectopia is an anomaly of the Pituitary gland associated with short stature and Growth Hormone deficiency. It is presumed to result from birth trauma causing a dysfunction between the Adenohypophysis and Neurohypophysis and is associated with deficiency of Anterior Pituitary hormones but preservation of Neurosecretory hormones. [3].It is a form of developmental anomaly due to incomplete downward growth and fusion of the Neurohypophysis with the Adenohypophysis in the Sella and may be a part of other midline cranial anomalies [4].

On MR the Sella appears smaller than normal on T1W images, the homogeneous signal of normal Pituitary is absent or small, with the absence of proximal pituitary stalk. A focal bright signal spot is seen in the proximal portion of the Infundibulum or the Tuber Cinereum which represents the ectopic position of the Neurohypophysis.The differential diagnosis of a Suprasellar bright spot include Rathkes Cleft Cyst, Subacute haemorrhage (in thrombosed Aneurysm), Haemorrhagic neoplasm, Post operative status, Lipoma, Dermoid, Traumatic transection of Stalk, Hypophysectomy, Sarcoidosis and Histiocytosis [5]. The commonest site for the bright spot of Posterior lobe is Median eminence or Infundibulum [6].

 
   References Top

1.David D.Stark, William G.Bradley, Magnetic Resonance Imaging,3rd edition, Volume III,Page 1228-1229.  Back to cited text no. 1    
2.Howard Lee S, Krishna Rao C.V.G., Zimmerman Robert a, Cranial MRI and CT, 4th Edition, Page 642-644  Back to cited text no. 2    
3.Fuzisawa I, Kikuchi K et al: Transection of the Pituitary stalk: Development of and Ectopic Posterior lobe assessed with MR imaging Radiology, 165:487-489, 1987.  Back to cited text no. 3    
4.KellyWM, Kucharezykuv et al: posterior Pituitary Ectopia:An MR feature of Dwarfism.AJNR 9:453-460, 1988  Back to cited text no. 4    
5.Anne G.Osborn, Diagnostic Neuroradiology, Page 471.  Back to cited text no. 5    
6.Abrahams TT Trafelner E and Boulware S: Idiopathic Growth Hormone Deficiency: MR findings in 35 Patients, AJR 156:599, 1991.  Back to cited text no. 6    

Top
Correspondence Address:
A L Kiranmayi
Department of Radiology, Yashoda Superspeciality hospital, Malakpet, Hyderabad-500036, Andhra Pradesh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.29082

Rights and Permissions


    Figures

[Figure - 1], [Figure - 2]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Email Alert *
    Add to My List *
* Registration required (free)  


    Introduction
    Case report
    Discussion
    References
    Article Figures

 Article Access Statistics
    Viewed3147    
    Printed96    
    Emailed0    
    PDF Downloaded255    
    Comments [Add]    

Recommend this journal