Mucosa-Associated Lymphoid Tissue Lymphoma of the Pituitary Gland: MR Imaging Features

Images in a 42-year-old man with 3-month history of blurred vision and a foreign-body sensation in his left eye.

A, Coronal fat-saturated T1-weighted MR image (TR/TE/NEX, 645/14/2) reveals an isointense mass in the sellar and suprasellar areas. The mass invades both parasellar regions and extends extracranially along both third branches of the trigeminal nerves through the widened foramina ovale. Note the focal bony erosion due to the mass (arrows) on the left side of the sphenoid body. The high signal intensity in the sellar mass suggests focal hemorrhage in the residual pituitary gland.

B, Coronal fat-saturated T2-weighted MR image (4300/132/3) shows the slight hypointensity of the mass. Note the mild luminal narrowing of the cavernous segment of the left internal carotid artery (arrow) compared with that of the contralateral side.

C, Contrast-enhanced fat-saturated coronal T1-weighted MR image (645/14/2) shows homogeneous, strong enhancement of the mass. Diffuse thickening of the mandibular branches of both trigeminal nerves (arrows) within the widened foramina ovale is also demonstrated. Note the strong enhancement of the left side of the mandibular nerve.

D, Contrast-enhanced fat-saturated sagittal T1-weighted MR image (645/14/2) demonstrates tumor spread along the clival dura with a long dural tail (arrows).

E, Photomicrograph of the specimen shows a lymphoproliferative lesion composed of centrocyte-like lymphocytes and cells with plasmacytoid features (hematoxylin-eosin stain, original magnification ×400).