42-year-old female with hyperprolactinemia and migraines. Evaluate for macroadenoma. MRI brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma appears unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. MRI pituitary:Dedicated images through the sella demonstrate a normal height of the pituitary gland. A tiny 2 mm oval lesion seen on sagittal imaging along the posterior inferior portion of the anterior pituitary gland and abuts the T1 bright spot is hypointense on T1, and is either nonenhancing or hypoenhancing on postcontrast images. Further evaluation is somewhat limited since all of the other sequences skip over the lesion. No additional focal abnormal signal intensity or mass is seen within the pituitary gland. The pituitary stalk deviates slightly to the left which may be within normal variation. Suprasellar cistern, optic chiasm, cavernous sinuses and intracranial portions of the optic nerves appear unremarkable.
No pituitary macroadenoma. Tiny 2 mm pituitary lesion, with location most suggestive of a tiny pars intermedia cyst along the posterior inferior portion of the anterior pituitary gland.