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Hypophysitis refers to inflammation of the pituitary gland (hypophysis), which can involve the anterior lobe (adenohypophysitis), posterior lobe (infundibulo-neurohypophysitis), or both (panhypophysitis). It can be primary (idiopathic/autoimmune) or secondary to other systemic or local diseases (e.g. infections, tumors, drugs).

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Classification

A. By Etiology:

Type	Description
Primary Hypophysitis	Autoimmune or idiopathic inflammation of pituitary
Secondary Hypophysitis	Caused by systemic diseases (e.g., sarcoidosis, IgG4-RD), tumors, infections, drugs (e.g., ipilimumab)

B. By Histopathology:

Subtype	Features
Lymphocytic hypophysitis	Most common; autoimmune; lymphocyte-predominant infiltrate
Granulomatous hypophysitis	Non-caseating granulomas; may mimic sarcoidosis or tuberculosis
Xanthomatous hypophysitis	Foamy histiocytes; usually isolated anterior lobe involvement
IgG4-related hypophysitis	Part of IgG4-related disease spectrum; plasma cell-rich infiltrate
Necrotizing hypophysitis	Rare; aggressive necrosis of pituitary tissue

Hypophysitis Subtype Comparison Chart

Epidemiology

Rare overall; often underdiagnosed
Lymphocytic type most common in young women, especially during late pregnancy or postpartum
Secondary forms can occur in both sexes and at any age depending on the underlying cause

Clinical Features

1. Mass Effect Symptoms:

Headache
Visual field defects (bitemporal hemianopsia if optic chiasm compressed)