Figures
Figure 1. Confluent mediastinal and right hilar adenopathy, likely represent metastatic disease. Peribronchovascular infiltrates in the right lower lobe.
Figure 2. There is a 2.6 × 1.2 × 1.3 sellar mass with intermediate signal intensity on T1 and T2-weighted images inseparable from pituitary gland and compressing optic chiasm. The mass abuts the right cavernous sinus without definite invasion.
Figure 3. EBUS showing the biopsy taken from right hilar lymph node.
Figure 4. Immunostains from EBUS showing ER+.
Figure 5. Pituitary mass histology revealed metastatic breast cancer with cytokeratin, ER, PR positive and Her 2 negative staining.
Figure 6. Bone marrow biopsy showed hypocellular marrow with normal M:E ratio with clusters of atypical cells positive for cytokeratin and ER receptors.
Figure 7. CT head showing moderate bilateral subdural effusions with early descending transtentorial herniation bilaterally.