Non-Hodgkin Lymphoma Causing Hypopituitarism Can Imaging Help Diagnosis and Management?
Non-Hodgkin lymphomas of the hypothalamus and pituitary are rare. They usually remain clinically silent until onset of compressive features affecting surrounding structures. When symptomatic, patients most commonly present with diabetes insipidus, headaches, ophthalmoplegia and/or bilateral hemianop...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SMC MEDIA SRL
2021-12-01
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| Series: | European Journal of Case Reports in Internal Medicine |
| Subjects: | |
| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/2980 |
| _version_ | 1818942556322398208 |
|---|---|
| author | Uzma Khan Anton Borg Radu Beltechi Hiten Mehta Timothy Robbins Harpal Randeva Pratibha Machenahalli |
| author_facet | Uzma Khan Anton Borg Radu Beltechi Hiten Mehta Timothy Robbins Harpal Randeva Pratibha Machenahalli |
| author_sort | Uzma Khan |
| collection | DOAJ |
| description | Non-Hodgkin lymphomas of the hypothalamus and pituitary are rare. They usually remain clinically silent until onset of compressive features affecting surrounding structures. When symptomatic, patients most commonly present with diabetes insipidus, headaches, ophthalmoplegia and/or bilateral hemianopia.
We report a case of a 67-year-old Caucasian female with a history of B-cell lymphoma in complete remission. She presented with left oculomotor nerve palsy and was subsequently found to have a sellar/suprasellar mass lesion on MRI. Alongside hypocortisolism and hypogonadotropic hypogonadism, she developed transient diabetes insipidus during her illness. Her clinical course was characterized by rapid intracranial progression of the sellar mass. MR spectroscopy suggested a diagnosis of lymphoma. Diagnostic biopsy confirmed high-grade diffuse large B-cell CNS lymphoma; this changed the definitive management from surgical excision to chemotherapy. Despite treatment, she succumbed to her illness within 7 months of initial presentation.
This case highlights the aggressive nature of CNS lymphomas and the need for a high index of suspicion in an unusual presentation of sellar/suprasellar mass lesions. |
| first_indexed | 2024-12-20T07:13:18Z |
| format | Article |
| id | doaj.art-2423d1d7fb33452f9eac20c8aa020786 |
| institution | Directory Open Access Journal |
| issn | 2284-2594 |
| language | English |
| last_indexed | 2024-12-20T07:13:18Z |
| publishDate | 2021-12-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj.art-2423d1d7fb33452f9eac20c8aa0207862022-12-21T19:48:51ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942021-12-0110.12890/2021_0029802515Non-Hodgkin Lymphoma Causing Hypopituitarism Can Imaging Help Diagnosis and Management?Uzma Khan0https://orcid.org/0000-0002-5559-9300Anton Borg1Radu Beltechi2Hiten Mehta3Timothy Robbins4Harpal Randeva5Pratibha Machenahalli6Department of Endocrinology & Diabetes, University Hospitals Coventry & Warwickshire NHS Trust, UKDepartment of Haematology, South Warwickshire NHS Foundation Trust, UK Department of Neurosurgery, University Hospitals Coventry & Warwickshire NHS Trust, UKDepartment of Clinical Radiology, University Hospitals Coventry & Warwickshire NHS Trust, UKDepartment of Endocrinology & Diabetes, University Hospitals Coventry & Warwickshire NHS Trust, UKDepartment of Endocrinology & Diabetes, University Hospitals Coventry & Warwickshire NHS Trust, UKDepartment of Endocrinology & Diabetes, University Hospitals Coventry & Warwickshire NHS Trust, UKNon-Hodgkin lymphomas of the hypothalamus and pituitary are rare. They usually remain clinically silent until onset of compressive features affecting surrounding structures. When symptomatic, patients most commonly present with diabetes insipidus, headaches, ophthalmoplegia and/or bilateral hemianopia. We report a case of a 67-year-old Caucasian female with a history of B-cell lymphoma in complete remission. She presented with left oculomotor nerve palsy and was subsequently found to have a sellar/suprasellar mass lesion on MRI. Alongside hypocortisolism and hypogonadotropic hypogonadism, she developed transient diabetes insipidus during her illness. Her clinical course was characterized by rapid intracranial progression of the sellar mass. MR spectroscopy suggested a diagnosis of lymphoma. Diagnostic biopsy confirmed high-grade diffuse large B-cell CNS lymphoma; this changed the definitive management from surgical excision to chemotherapy. Despite treatment, she succumbed to her illness within 7 months of initial presentation. This case highlights the aggressive nature of CNS lymphomas and the need for a high index of suspicion in an unusual presentation of sellar/suprasellar mass lesions.https://www.ejcrim.com/index.php/EJCRIM/article/view/2980non-hodgkin lymphomacns lymphomapituitary macroadenomasellar mass |
| spellingShingle | Uzma Khan Anton Borg Radu Beltechi Hiten Mehta Timothy Robbins Harpal Randeva Pratibha Machenahalli Non-Hodgkin Lymphoma Causing Hypopituitarism Can Imaging Help Diagnosis and Management? European Journal of Case Reports in Internal Medicine non-hodgkin lymphoma cns lymphoma pituitary macroadenoma sellar mass |
| title | Non-Hodgkin Lymphoma Causing Hypopituitarism Can Imaging Help Diagnosis and Management? |
| title_full | Non-Hodgkin Lymphoma Causing Hypopituitarism Can Imaging Help Diagnosis and Management? |
| title_fullStr | Non-Hodgkin Lymphoma Causing Hypopituitarism Can Imaging Help Diagnosis and Management? |
| title_full_unstemmed | Non-Hodgkin Lymphoma Causing Hypopituitarism Can Imaging Help Diagnosis and Management? |
| title_short | Non-Hodgkin Lymphoma Causing Hypopituitarism Can Imaging Help Diagnosis and Management? |
| title_sort | non hodgkin lymphoma causing hypopituitarism can imaging help diagnosis and management |
| topic | non-hodgkin lymphoma cns lymphoma pituitary macroadenoma sellar mass |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/2980 |
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