Non-Hodgkin B-cell Lymphoma Presenting as a Pituitary Mass

Arsen Seferi; Majlinda Ikonomi; Ejona Lilamani; Gentian Vyshka

doi:10.3889/oamjms.2023.11027

Authors

Arsen Seferi Department of Neurosurgery, University Hospital Center “Mother Theresa”, Tirana, Albania
Majlinda Ikonomi Department of Pathological Anatomy, University Hospital Center “Mother Theresa”, Tirana, Albania
Ejona Lilamani Department of Neurosurgery, University Hospital Center “Mother Theresa”, Tirana, Albania
Gentian Vyshka Biomedical and Experimental Department, Faculty of Medicine, University of Medicine, Tirana, Albania https://orcid.org/0000-0001-5286-1265

DOI:

https://doi.org/10.3889/oamjms.2023.11027

Keywords:

Pituitary gland, Lymphomas, Non-Hodgkin B-cell lymphoma, Surgery

Abstract

INTRODUCTION: The authors describe the case of a pituitary mass considered from the radiological point of view as a non-secretory adenoma.

CASE REPORT: The patient, a 31-year-old male, presented with an intense headache, non-responsive to antalgics, right eye Mydriasis, and semiptosis. An endoscopic transnasal surgery caused important but temporary relief to the patient, who some days later complained of tumefactions in both axillar regions. Pathological diagnosis was of a non-Hodgkin B-cell lymphoma.

CONCLUSIONS: Although pituitary involvement is rare in the case of systemic lymphomas, and even rarer among primary central nervous system malignancies, this possibility must become part of differential diagnosis when approaching pituitary masses.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

Author Biography

Ejona Lilamani, Department of Neurosurgery, University Hospital Center “Mother Theresa”, Tirana, Albania

Service of Neurosurgery, University Hospital Center “Mother Theresa”, Tirana

References

Sözen M, Bayrak BY, Selek A, Cantürk Z, Çetinarslan B, Gezer E. Primary hypothalamic lymphoma with clinical findings mimicking pituitary apoplexy: A case report. J Med Case Rep. 2021;15(1):293. https://doi.org/10.1186/s13256-021-02866-7 PMid:34030739

Tamer G, Kartal I, Aral F. Pituitary infiltration by non-Hodgkin’s

lymphoma: A case report. J Med Case Rep. 2009;3:9293. https://doi.org/10.1186/1752-1947-3-9293 PMid:20062782

Wang A, Carberry N, Solli E, Kleinman G, Tandon A. Metastatic mantle cell lymphoma to the pituitary gland: Case report and literature review. Case Rep Oncol. 2016;9(1):25-32. https://doi.org/10.1159/000443682

Javanbakht A, D’Apuzzo M, Badie B, Salehian B. Pituitary metastasis: A rare condition. Endocr Connect. 2018;7(10):1049-57. https://doi.org/10.1530/EC-18-0338 PMid:30139817

Shimon I. Metastatic spread to the pituitary. Neuroendocrinology.2020;110(9-10):805-8. https://doi.org/10.1159/000506810 PMid:32101869

Tarabay A, Cossu G, Berhouma M, Levivier M, Daniel RT, Messerer M. Primary pituitary lymphoma: An update of the literature. J Neurooncol. 2016;130(3):383-95. https://doi.org/10.1007/s11060-016-2249-z PMid:27581598

Giustina A, Gola M, Doga M, Rosei EA. Clinical review 136: Primary lymphoma of the pituitary: An emerging clinical entity. J Clin Endocrinol Metab. 2001;86(10):4567-75. https://doi.org/10.1210/jcem.86.10.7909 PMid:11600505

Kaufmann TJ, Lopes MB, Laws ER Jr., Lipper MH. Primary sellar lymphoma: Radiologic and pathologic findings in two patients. AJNR Am J Neuroradiol. 2002;23(3):364-7. PMid:11901000

Khan U, Borg A, Beltechi R, Mehta H, Robbins T, Randeva H, et.al. Non-hodgkin lymphoma causing hypopituitarism can imaging help diagnosis and management? Eur J Case Rep Intern Med. 2021;8(12):002980. https://doi.org/10.12890/2021_002980 PMid:35059332

Wen W, Wang L, Li M, Li P, Ren Y, Zhang X. 41-year-old male with a pituitary mass. Brain Pathol. 2021;31(6):e12961. https://doi.org/10.1111/bpa.12961 PMid:34286902

Wilkie MD, Al-Mahfoudh R, Javadpour M. A rare case of primary sellar lymphoma presenting a diagnostic challenge. Br J Neurosurg. 2012;26(5):782-3. https://doi.org/10.3109/02688697.2012.674578 PMid:22540964

Rizek P, Seitelbach M, Alturkustani M, Leung A, Fraser JA. Sellar and parasellar intravascular lymphoma mimicking pituitary apoplexy. J Neuroophthalmol. 2012;32(1):33-7. https://doi.org/10.1097/WNO.0b013e31823f457e PMid:22173269

Morita K, Nakamura F, Kamikubo Y, Mizuno N, Miyauchi M, Yamamoto G, et al. Pituitary lymphoma developing within pituitary adenoma. Int J Hematol. 2012;95(6):721-4. https://doi.org/10.1007/s12185-012-1075-0 PMid:22527852

Yang J, Zhao N, Zhang G, Zheng W. Clinical features of patients with non-Hodgkin’s lymphoma metastasizing to the pituitary glands. Oncol Lett. 2013;5(5):1643-8. https://doi.org/10.3892/ol.2013.1266 PMid:23760877

Li Y, Zhang Y, Xu J, Chen N. Primary pituitary lymphoma in an immunocompetent patient: A rare clinical entity. J Neurol. 2012;259(2):297-305. https://doi.org/10.1007/s00415-011-6179-6 PMid:21932128

Ozdemir ES, Yildirim AE, Can AY. Primary central nervous system lymphoma of optic chiasma: Endoscopic endonasal treatment. J Craniofac Surg. 2018;29(1):199-201. https://doi.org/10.1097/SCS.0000000000004059 PMid:29065048

Musleh W, Sonabend AM, Lesniak MS. Role of craniotomy in the management of pituitary adenomas and sellar/parasellar tumors. Expert Rev Anticancer Ther. 2006;6(Suppl 9):S79-83. https://doi.org/10.1586/14737140.6.9s.S79 PMid:17004861

Davis RL, Robertson DM, editors. Textbook of Neuropathology. 2nd ed. Baltimore MD, United States: Williams and Wilkins; 1991. p. 491-2.

Schlegel U, Schmidt-Wolf IG, Deckert M. Primary CNS lymphoma: Clinical presentation, pathological classification, molecular pathogenesis and treatment. J Neurol Sci. 2000;181(1-2):1-12. https://doi.org/10.1016/s0022-510x(00)00385-3 PMid:11099705

Batara JF, Grossman SA. Primary central nervous system lymphomas. Curr Opin Neurol. 2003;16(6):671-5. https://doi.org/10.1097/01.wco.0000102624.38669.2b PMid:14624075

Ouyang T, Wang L, Zhang N, Zhang Z, Xiong Y, Li M, et al. Clinical characteristics, surgical outcomes, and prognostic factors of intracranial primary central nervous system lymphoma. World Neurosurg. 2020;139:e508-16. https://doi.org/10.1016/j.wneu.2020.04.049 PMid:32311566

Haldorsen IS, Espeland A, Larsson EM. Central nervous system lymphoma: Characteristic findings on traditional and advanced imaging. AJNR Am J Neuroradiol. 2011;32(6):984-92. https://doi.org/10.3174/ajnr.A2171 PMid:20616176