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Malignant lymphoma in the parasellar region
Takao Koiso1, Hiroyoshi Akutsu1, Shingo Takano1
1Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki 305-8575, Japan.
Case Reports in Medicine
|March 25, 2014
Summary
Secondary pituitary lymphoma (SPL) is rare, but this case shows a good prognosis. Early diagnosis using MRI and sIL-2R levels aids in identifying this uncommon condition.
Area of Science:
- Oncology
- Neurology
- Radiology
Background:
- Pituitary lymphoma, encompassing primary pituitary lymphoma (PPL) and secondary pituitary lymphoma (SPL), is exceptionally rare.
- Secondary pituitary lymphoma involves systemic lymphoma, making diagnosis challenging due to non-specific clinical and radiological findings.
Purpose of the Study:
- To report a case of secondary pituitary lymphoma with a favorable prognosis.
- To highlight diagnostic clues for pituitary lymphoma, including MRI characteristics and serum biomarkers.
Main Methods:
- A 78-year-old female patient presented with diplopia, ptosis, and back pain.
- Diagnostic workup included magnetic resonance (MR) imaging, transsphenoidal exploration with biopsy, bone marrow aspiration, and computed tomography (CT).
Main Results:
- MR imaging revealed parasellar and vertebral mass lesions.
- Transsphenoidal biopsy confirmed diffuse large B-cell lymphoma, and further tests indicated systemic involvement (SPL).
- The patient achieved complete remission for 4 years following chemotherapy.
Conclusions:
- Pituitary lymphoma diagnosis often requires biopsy due to lack of specific findings.
- T2 hypointensity on MR imaging and elevated serum soluble interleukin-2 receptor (sIL-2R) levels may aid in differentiating pituitary lymphoma from other sellar lesions.
