Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0079731 (B-cell lymphoma)
 16,671 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 66-yr-old man presented with presyncopal episodes, dizziness, anorexia, nausea, and weight loss and was noted to have low blood pressure with a postural drop and sparse eyebrows. Laboratory investigations revealed evidence of hypopituitarism. Magnetic resonance imaging (MRI) revealed a non-enhancing mass arising from the adenohypophysis. The neurohypophysis was displaced laterally but appeared otherwise normal. The lesion was thought to be a nonfunctioning pituitary adenoma and a trans-sphenoidal hypophysectomy was performed. Histologically, this lesion was a diffuse large B-cell lymphoma that had features of a high grade mucosa associated lymphoid tissue (MALT)-type lymphoma arising in association with low-grade B-cell lymphoma of MALT type. There was no clinical or radiological evidence of lymphoma in other sites and there was no evidence of an immunocompromised state. Only one previous case of primary malignant lymphoma of the pituitary has been reported and this patient presented with compression of the optic chiasm. We describe the clinical and pathological features of a patient who presented with hypopituitarism and was found to have a pituitary lymphoma. This is the first reported case of a pituitary lymphoma presenting with pituitary failure and the first case characterized by lymphocyte-marker studies that confirmed it to be a B-cell lymphoma.
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PMID:Primary Lymphoma of Pituitary Gland: A Neoplasm of Acquired Malt? 1211 95

We report a rare case of primary pituitary lymphoma in a 75-year-old immunocompetent woman. The patient was blind in the right eye and presented with visual disturbance in the left eye that started 2 months previously. She also exhibited right third and fifth cranial nerve palsy. Magnetic resonance imaging(MRI)revealed an intrasellar mass lesion with right cavernous sinus invasion and suprasellar extension with compression of the optic chiasm. The mass lesion was isointense on both T1WI and T2WI, and showed less enhancement than a normal pituitary gland on gadolinium-enhanced T1WI. We therefore suspected the tumor to be a nonfunctioning pituitary adenoma. The patient underwent endoscopic endonasal transsphenoidal surgery. The tumor was firm and grayish, and had an ill-defined border along the normal pituitary gland. Histological examination revealed a malignant CD5-positive diffuse large B-cell lymphoma. After surgery, the patient received both chemotherapy and radiotherapy. Although the visual acuity of the right eye did not improved, other symptoms improved. At the 34-month follow-up, no recurrence was detected on serial MRI. Patients with primary pituitary lymphoma often exhibit ophthalmoplegia and/or panhypopituitarism more frequently than expected from radiological findings. In cases of pituitary tumors with atypical symptoms, a biopsy and general physical examination should be performed immediately to determine the diagnosis and perform adjuvant therapy even when the tumor is assumed as nonfunctioning pituitary adenoma from the image findings.
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PMID:[Primary Pituitary Malignant Lymphoma that was Difficult to Differentiate from Nonfunctioning Pituitary Adenoma:A Case Report]. 2760 81