Hypothalamic lesions

1. Cranipharyngioma - solid and cystic, bimodal, enhance
2. Germinoma - upper part of infundibulum, solid, enhance, a/w pineal germinoma
3. Hypothalamic hamartoma - tuber cinerium, solid with cysts, no enhancement, no calcium
4. Osteolipoma (lipoma) - tuber cinerium, fat and osteoid
5. Dermoid cyst - midline, fat, no enhancement
6. Epidermoid cyst - parasellar, CSF signal but high signal on FLAIR, no enhancement
7. Arachnoid cyst - typical
8. Rathke's cleft cyst - variable signal, no enhancement, no calcium
9. Colloid cyst - variable signal, rim may enhance, no calcium
10. Hypothalamic chiasmatic glioma - solid, enhance
11. Ganglioglioma - solid with cystic component, nodular or solid enhancement
12. Choristoma (low grade glioma) - infundibulum, isointense, variable enhancement
13. Perisellar meningioma - typical
14. Hemangioblastoma - cyst with enhancing mural nodule, a.w VHL syndrome
15. Cavernoma - typical
16. Metastasis - intense enhancement, bone destruction, no sellar enlargement
17. Lymphoma
18. Leukemia
19. Langercells histiocytosis - paediatric, stalk > 3mm, intense enhancement
20. Hymphocytic infundibuloneurohypophysitis
21. Sarcoidosis - stalk, a/w leptomeningeal enhancement
22. Wegener's granulomatosis
23. Tuberculosis
24. Syphilis
25. Encephalitis
26. Suprasellar pituitary tumour - enhance
27. Ectopic posterior pituitary
28. Aneurysm - blood products
    
    Reference:
    Saleem SN et al. Lesions of the Hypothalamus: MR Imaging Diagnostic Features. RadioGraphics 2007;27:1087-1108