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Chronic lymphocytic leukemia presenting as a pituitary mass lesion
J S Fain1, F Naeim, D P Becker
1Department of Pathology, UCLA Medical Center 90024-1732.
Insights
A rare case of chronic lymphocytic leukemia (CLL) presented as a pituitary mass, causing vision loss and hormonal deficiencies. This unique presentation highlights CLL
Area of Science:
- Neuro-oncology
- Hematology
- Endocrinology
Background:
- Chronic lymphocytic leukemia (CLL) is a hematologic malignancy.
- Pituitary masses can cause significant neurological and endocrine dysfunction.
Observation:
- A patient presented with bitemporal hemianopsia, adrenal insufficiency, and gonadotrophin deficiency.
- Imaging revealed an intrasellar mass with suprasellar extension, compressing the optic chiasm.
- Leukemic cells infiltrated the pituitary gland.
Findings:
- Peripheral blood and CSF studies confirmed B-cell CLL with monoclonal IgM kappa expression.
- Biopsy of the pituitary mass showed dense infiltration by CLL cells.
Implications:
- This is the first reported case of CLL presenting primarily as a pituitary mass.
- Highlights the importance of considering systemic malignancies in pituitary lesions.
Abstract:
We describe a unique case of chronic lymphocytic leukemia (CLL) in a patient who presented with bitemporal hemianopsia, adrenal insufficiency, and gonadotrophin deficiency. Studies revealed an enhancing intrasellar mass with suprasellar extension and displacement of the optic chiasm. Peripheral blood and cerebrospinal fluid (CSF) studies disclosed a monoclonal IgM kappa expressing B-cell CLL. Biopsy of the pituitary mass revealed dense infiltration of the pituitary gland by leukemic cells. This is, to our knowledge, the first reported case of CLL presenting as a pituitary mass lesion.