Primary Pituitary Lymphoma As Rare Cause Of A Pituitary Mass And Hypopituitarism In Adulthood

Caputo, Marina; Prencipe, Nunzia; Bisceglia, Alessandro; Bona, Chiara; Maccario, Mauro; Aimaretti, Gianluca; Grottoli, Silvia; Gasco, Valentina

doi:10.4158/ep-2020-0286

Cited by 7 publications

(33 citation statements)

References 55 publications

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“…In some patients, expansive sellar mass may be the first sign of an otherwise unrecognized hematological malignancy. Systemic symptoms and some abnormal laboratory parameters (such as ESR, blood count, LDH levels, presence of paraprotein), more specific for hematological diseases, could support diagnosis of sellar hematological malignancy, as was the case in most of our patients [16]. All our patients were in poor general condition, with malaise, and all of them had elevated ESR and disturbed blood count.…”

Section: Discussionsupporting

confidence: 59%

“…Our patients were immunocompetent, middle aged females (mean age 55.2 years). In other studies, there was male predominance with sellar lymphoma (57%), or absence of significant gender differences [8,15,16].…”

Section: Discussionmentioning

confidence: 68%

“…There are case reports and a few large studies of primary pituitary lymphoma [8,[14][15][16]. The majority of cases were B-cell lymphomas (more than 80%), while other cases of non-Hodgkin lymphoma (Burkitt, T-cell, NK/T cell lymphoma, MALT) and Hodgkin lymphoma involving the pituitary have been reported even more rarely [8,[15][16][17][18][19][20]. Nasopharyngeal B-cell lymphoma may also infiltrate the pituitary region, causing hypopituitarism and cranial nerve palsy [21].…”

Section: Discussionmentioning

confidence: 99%

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The sellar region as presenting theater for hematologic malignancies—A 17-year single-center experience

et al. 2022

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Hematological neoplastic mass lesions of the sellar region are rare. We identified five cases of hematological malignancy with first presentation in the sellar region from our departmental database of 1,405 patients (0.36%) with sellar lesions diagnosed over the 17-year period (2005-2021). All patients were females (mean age 55.2 ± 3.4 years). One patient had multiple myeloma (MM), one patient had acute myeloid leukemia (AML), while three other patients had lymphoma (intravascular lymphoma (IVL, n = 1) or non-Hodgkin's lymphoma (NHL, n = 2). Most patients presented with ophthalmoplegia, and one patient with diabetes insipidus (DI), with short duration of symptoms (median 30 days). All patients had an elevated erythrocyte sedimentation rate and altered blood count, while patients with lymphoma had elevated lactate dehydrogenase (LDH). Sellar mass was demonstrated in three patients while the patient with IVL had an empty sella and in the AML patient posterior lobe T1W hyperintensity was lost. Two patients (IVL and NHL) presented with multiple anterior pituitary deficiencies and one patient (AML) had DI. All patients were treated with chemotherapy. Two patients responded well to treatment (one had reversed hypopituitarism), while three patients died. Differential diagnosis of sellar-parasellar pathology should include suspicion of hematological malignancy, particularly in patients with short duration of nonspecific symptoms, neurological signs (ophthalmoplegia), blood count alterations and LDH elevation, pituitary dysfunction and imaging features atypical for pituitary adenoma. Early diagnosis is crucial for timely initiation of hematological treatment aimed at inducing disease remission and partial or full recovery of pituitary function.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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The sellar region as presenting theater for hematologic malignancies—A 17-year single-center experience

et al. 2022

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“…This paper presented a rare and unusual case of PPL with only 40 immunocompetent cases identified and reported to date in the entire literature (5). Although PPL is an intracranial lesion, these lesions have different embryological origins than the usual CNS origin.…”

Section: Discussionmentioning

confidence: 97%

“…Although Tarabay et al in 2016 observed a slight female predominance in the distribution of cases (female:male ratio 1.35:1), this difference was not seen in the recent studies (female:male ratio 1:1 and 1.12:1, respectively). Moreover, it can appear in all age groups, with a peak incidence observed between the 5 th and the 6 th decade of life (5)(6)(7). Pituitary lymphoma can be either primary or secondary.…”

Section: Discussionmentioning

confidence: 99%