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Case Reports
. 2022 Oct 27;6(12):bvac161.
doi: 10.1210/jendso/bvac161. eCollection 2022 Oct 26.

Pituitary Infiltration by Lymphoma

Víctor Hugo Tovar-Méndez  1 , Dalia Cuenca  1 , Francisco J Gómez-Pérez  1 , Daniel Cuevas-Ramos  1
Affiliations
Case Reports

Pituitary Infiltration by Lymphoma

Víctor Hugo Tovar-Méndez et al. J Endocr Soc. .

Abstract

Lymphoma infiltration to the pituitary is rare. It represents less than 0.5% of all reported pituitary metastases (PMs). Here we present a case series of 3 patients with PMs from a systemic lymphoma. Also, we performed a literature review of the cases reported. We identified additional 31 cases in which non-Hodgkin lymphoma (NHL) was the most common (n = 28, 90%), with large B-cell NHL the most frequent histological subtype (n = 14, 45%). Central hypothyroidism (n = 21, 67%) was the most frequent pituitary deficiency followed by adrenal insufficiency (n = 19, 61%) and diabetes insipidus (DI; n = 18, 58%). Full endocrine recovery was found in only 12% (n = 4) of patients after treatment, and magnetic resonance imaging showed tumor regression in 22% of them. In our series, 2 patients were diagnosed with diffuse large B-cell lymphoma, and 1 had mixed cellularity of classic Hodgkin lymphoma. The mean age was 54 ± 6.92 years. Hypopituitarism and DI were present in all of them, with 100% of mortality because of advanced systemic disease.

Keywords: anterior pituitary; cancer; hypopituitarism; infiltrative disease.

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Figures

Figure 1.
Figure 1.
A, Magnetic resonance imaging of case 1 with sellar, hypothalamic, and skull base infiltration of non-Hodgkin lymphoma (arrowhead) with intraorbital extension (arrow). B, F-FDG positron emission tomography/computed tomography showing a hypermetabolic hypothalamic lesion.
Figure 2.
Figure 2.
Coronal T2, contrast-enhanced sequence of the magnetic resonance imaging of case 3, showing tumor volume before (left, white arrow) and after (right, white arrow) chemotherapy.
Figure 3.
Figure 3.
Histopathologic diagnosis of pituitary biopsy of the previously reported cases with systemic lymphoma (n = 31).
Figure 4.
Figure 4.
Hormonal abnormalities reported in patients with lymphoma pituitary infiltration (n = 34).
See this image and copyright information in PMC

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