 Dedicated images through the sella demonstrate a slightly enlarged bony sella which is CSF density filled consistent with partially empty sella as there is minimal enhancing pituitary tissue along the floor identified. This appearance is stable since prior MRI from August 2015. No focal abnormal signal intensity or mass is seen within the pituitary gland. The pituitary stalk lies in the midline. Suprasellar cistern, optic chiasm, cavernous sinuses and intracranial portions of the optic nerves appear unremarkable.Left Meckel's cave is slightly larger than the right, likely normal variant. Minimal fluid is also seen along the left inferior meatus.There is mild mucosal thickening in the visualized left maxillary sinus.
Stable appearance of slightly enlarged bony sella (which may been referenced on the outside sinus CT), with partially empty appearance and therefore no enlargement of the pituitary gland itself, as questioned. This appearance is stable since August 2015 and is most often an incidental finding especially in the setting of other prominent subarachnoid spaces as noted in this patient, although the finding can be associated with pseudotumor cerebri. 