This patient went on to have transphenoidal surgery. 

Histology

Paraffin sections show fragments of a moderately hypercellular adenoma. Tumour cells have regular nuclear features and a variable amount of pale cytoplasm and are arranged in trabeculae and diffuse sheets intersected by thin-walled capillaries. No mitotic figures or areas of necrosis are seen. No normal anterior pituitary tissue is included. Immunohistochemistry shows moderately strong cytoplasmic staining for FSH in tunmour cells. No staining for growth hormone, prolactin, ACTH, LH, TSH or CAM5.2 is seen in tumour cells. The features are of a non-functioning gonadotroph cell adenoma. The topoisomerase labelling index is <1%.

FINAL DIAGNOSIS: Pituitary tumour: Non-functioning gonadotroph cell adenoma.

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