Incidence of metastatic disease to the hypothalamic-pituitary area is low (1 to 6% in most studies), the lung and the prostate being the most common primary sites in men. Clinical presentation as panhypopituitarism is rare (0.2 to 0.8%) in patients with bronchogenic carcinoma. The authors describe a case of a man with diagnosis of squamous cell carcinoma of the lung that, during the clinical course of the disease, presented clinical and laboratorial evidence of panhypopituitarism, with an expansive sellar and supra-sellar lesion image in the CT scan of the brain.

Keywords: Panhypopituitarism. Bronchogenic carcinoma. Hypothalamic-pituitary metastases.

Hypersensitivity pneumonitis is an immunologic lung disease caused by chronic inhalation of chemicals or organic dusts. Its chronic stage makes diagnosis more difficult because other interstitial diseases share the same clinical and radiological presentation, usually requiring open lung biopsy to confirm the diagnosis. The authors reviewed the confirmed cases in the last 11 years at the Thoracic Diseases Institute [Instituto de Doenças do Tórax] of the Rio de Janeiro Federal University [UFRJ]. In this period, eight cases were confirmed by histopathological studies. Main symptoms were dyspnea and coughing. All cases showed interstitial infiltrates on radiological studies and restrictive functional patterns were found in 70% of the cases. All seven patients treated with corticosteroids responded with improved clinical symptoms, although some did not have radiological or functional response. Once the diagnosis is established, patients must avoid the causative environment because the disease may progress to fibrosis if exposition continues.

Keywords: Extrinsic allergic alveolitis. Case-control studies. Diagnosis.