Correspondence

Reversible hypothalamic-pituitary axis involvement in a patient with intravascular lymphomatosis

Discussion

Striking MRI finding in our case was a marked enhancement of hypothalamic-pituitary axis, resolving after treatment.

IVL is a rare and aggressive variant of non-Hodgkin's lymphoma characterized by small vessels’ occlusion due to malignant lymphomatous cells, with a predilection for central nervous system and skin [1], [2]. Early diagnosis is crucial because an aggressive chemotherapy is potentially curative.

In only 25% of cases, the disease is limited to the skin, including petechias, purpura,

Conclusion

We report a unique case in which IVL involved the hypothalamic-pituitary axis without failure of the axis. Therefore, gadolinium enhancement of the hypothalamic-pituitary axis should be added to the features of the disease.

Disclosure of interest

The authors declare that they have no conflicts of interest concerning this article.

Acknowledgements

We thank Dr Valérie Rigau, department of clinical pathology, university hospital center of Montpellier, for performing the pathological and immunohistochemical examination.