Case ReportAnterior panhypopituitarism in diffuse large B-cell stage IV lymphoma
Section snippets
Case report
A 69-year-old man presented with dizziness at the emergency room. He had a history of a few months of weight loss, strabismus of the right eye and a superficial mass on the right upper abdomen. He had fever and postural hypotension. The superficial abdominal wall mass was in the right upper quadrant and approximately 2–3 cm in size, and the patient also had a right third cranial nerve palsy. Initial laboratory work-up showed hyponatremia and anemia with an elevated erythrocyte sedimentation
Discussion
Reports of individuals with metastatic lymphoma of the pituitary gland often describe involvement of the stalk and/or posterior pituitary, or both lobes [1]. In these cases, diabetes insipidus (DI) is the most common clinical manifestation. The posterior lobe is more susceptible to metastases due to its systemic blood supply from the hypophyseal arteries whereas the anterior lobe is nourished by the portal venous system and secondarily by the lower infundibular stem which partly arises from the
Conflicts of Interest/Disclosures
The authors declare that they have no financial or other conflicts of interest in relation to this research and its publication.
References (10)
- et al.
Differential diagnosis of sellar masses
Endocrinol Metab Clin North Am
(1999) Central nervous system lymphoma
Radiol Clin North Am
(1990)- et al.
Tumors metastatic to the pituitary gland: case report and literature review
J Clin Endocrinol Metab
(2004) - et al.
Metastatic malignancy presenting as anterior pituitary failure
Neth J Med
(1987) - et al.
Pituitary infiltration by non-Hodgkin’s lymphoma: a case report
J Med Case Rep
(2009)
Cited by (4)
A Unique Case of Central Hypopituitarism and Central Diabetes Insipidus Caused By Diffuse Large B-Cell Lymphoma
2019, AACE Clinical Case ReportsCitation Excerpt :Hamilton et al (9) classified pituitary infundibular lesions by categories of tumor, inflammatory/infectious, and congenital, of which, in their study population, 37% were malignant tumor, 33% were congenital, and 30% were inflammatory. Search of the literature yielded diverse case reports of central DI that occur secondary to sarcoidosis (10), granulomatosis with polyangiitis (11), Sjögren syndrome, Langerhans cell histiocytosis, systemic lupus erythematosus, as well as malignancy, with the most common being germinomas (12,13), lymphoma (14–16), and metastases from solid tumors (most commonly breast and lung) (17). In a study by the Mayo Clinic of the neoplastic pituitary stalk lesions identified on MRI, 18% were caused by lymphomas, 12% caused by germinomas, 12% caused by metastatic breast cancer, and 10% by metastatic small cell lung cancer.
Pituitary Infiltration by Lymphoma
2022, Journal of the Endocrine SocietyDiffuse large B cell lymphoma with bilateral adrenal and hypothalamic involvement: A case report and literature review
2019, World Journal of Clinical CasesFemale patients with lymphoma demonstrate diminished ovarian reserve even before initiation of chemotherapy when compared with healthy controls and patients with other malignancies
2016, Journal of Assisted Reproduction and Genetics