Headache. Follow-up of pituitary mass. There is a 5 mm, relatively well-circumscribed focus of no contrast enhancement within the superior aspect of the anterior pituitary gland. It is at least partly hyperintense on T2 imaging, relative to the remainder of the gland. It has no lateral parasellar extension. The cavernous sinuses are unremarkable. Overall volume of the pituitary gland is not increased and the suprasellar cistern is preserved. The optic chiasm is unaffected. The pituitary infundibulum is midline.The remainder of the pituitary gland is notable for a 2 mm focus of no contrast enhancement situated between the posterior and anterior pituitary glands, which probably represents an incidental pars intermedia cyst.Included brain is notable for serial changes of chronic microvascular ischemia and previous infarcts. Please refer to the brain MRI report from September 16, 2015 for more details. A 2 cm left upper cervical lymph node has a preserved fatty hilum and not significant change since September 2015.
1.5 mm focus of no contrast enhancement within the anterior pituitary gland would not be compatible with the typical MR characteristics of microadenoma (which typically show mild or delayed contrast enhancement). It may represent a small cyst. There is no extrasellar extension. 2.Changes of chronic microvascular ischemia and previous infarcts in the included brain are better assessed on the brain MRI from September 16, 2015.