Malignant Lymphoma in the Parasellar Region

The entity of pituitary (sellar or parasellar) lymphoma includes primary pituitary lymphoma (PPL) and secondary pituitary lymphoma (SPL). The latter has an involvement of systemic lymphoma. Both of these lymphomas are extremely rare. We describe a patient with SPL showing a good prognosis. A 78-yea...

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Main Authors: Takao Koiso, Hiroyoshi Akutsu, Shingo Takano, Tetsuya Yamamoto, Eiichi Ishikawa, Yasushi Okoshi, Akira Matsumura
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2014/747280
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author Takao Koiso
Hiroyoshi Akutsu
Shingo Takano
Tetsuya Yamamoto
Eiichi Ishikawa
Yasushi Okoshi
Akira Matsumura
author_facet Takao Koiso
Hiroyoshi Akutsu
Shingo Takano
Tetsuya Yamamoto
Eiichi Ishikawa
Yasushi Okoshi
Akira Matsumura
author_sort Takao Koiso
collection DOAJ
description The entity of pituitary (sellar or parasellar) lymphoma includes primary pituitary lymphoma (PPL) and secondary pituitary lymphoma (SPL). The latter has an involvement of systemic lymphoma. Both of these lymphomas are extremely rare. We describe a patient with SPL showing a good prognosis. A 78-year-old woman presented with diplopia, left ptosis, and back pain. Magnetic resonance (MR) imaging revealed a parasellar mass lesion extending to the upper clivus and another mass lesion with compression fracture of the Th3 vertebral body. Transsphenoidal exploration was performed, and it showed diffuse large B-cell lymphoma. Based on the positive tumor cells in the following bone marrow aspiration and hepatosplenomegaly in computed tomography (CT) findings, this patient was diagnosed as having a pituitary involvement of systemic lymphoma. After chemotherapy, she achieved complete remission for 4 years. The entity of pituitary lymphoma is extremely rare. Nineteen cases of PPL and 16 cases of SPL have been reported. Generally, clinical and radiological diagnosis was difficult because there are no specific findings. Therefore, biopsy was necessary in all of the cases. T2 hypointensity of a lesion in MR imaging in addition to an elevated serum level of soluble interleukin-2 receptor (sIL-2R) in a patient with a sellar lesion can be useful clues for the differential diagnosis of this rare disease.
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spelling doaj-art-d2dd6413ab11469dad55f9001aa0d73f2025-02-03T00:59:52ZengWileyCase Reports in Medicine1687-96271687-96352014-01-01201410.1155/2014/747280747280Malignant Lymphoma in the Parasellar RegionTakao Koiso0Hiroyoshi Akutsu1Shingo Takano2Tetsuya Yamamoto3Eiichi Ishikawa4Yasushi Okoshi5Akira Matsumura6Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki 305-8575, JapanDepartment of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki 305-8575, JapanDepartment of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki 305-8575, JapanDepartment of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki 305-8575, JapanDepartment of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki 305-8575, JapanDepartment of Hematology, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki 305-8575, JapanDepartment of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki 305-8575, JapanThe entity of pituitary (sellar or parasellar) lymphoma includes primary pituitary lymphoma (PPL) and secondary pituitary lymphoma (SPL). The latter has an involvement of systemic lymphoma. Both of these lymphomas are extremely rare. We describe a patient with SPL showing a good prognosis. A 78-year-old woman presented with diplopia, left ptosis, and back pain. Magnetic resonance (MR) imaging revealed a parasellar mass lesion extending to the upper clivus and another mass lesion with compression fracture of the Th3 vertebral body. Transsphenoidal exploration was performed, and it showed diffuse large B-cell lymphoma. Based on the positive tumor cells in the following bone marrow aspiration and hepatosplenomegaly in computed tomography (CT) findings, this patient was diagnosed as having a pituitary involvement of systemic lymphoma. After chemotherapy, she achieved complete remission for 4 years. The entity of pituitary lymphoma is extremely rare. Nineteen cases of PPL and 16 cases of SPL have been reported. Generally, clinical and radiological diagnosis was difficult because there are no specific findings. Therefore, biopsy was necessary in all of the cases. T2 hypointensity of a lesion in MR imaging in addition to an elevated serum level of soluble interleukin-2 receptor (sIL-2R) in a patient with a sellar lesion can be useful clues for the differential diagnosis of this rare disease.http://dx.doi.org/10.1155/2014/747280
spellingShingle Takao Koiso
Hiroyoshi Akutsu
Shingo Takano
Tetsuya Yamamoto
Eiichi Ishikawa
Yasushi Okoshi
Akira Matsumura
Malignant Lymphoma in the Parasellar Region
Case Reports in Medicine
title Malignant Lymphoma in the Parasellar Region
title_full Malignant Lymphoma in the Parasellar Region
title_fullStr Malignant Lymphoma in the Parasellar Region
title_full_unstemmed Malignant Lymphoma in the Parasellar Region
title_short Malignant Lymphoma in the Parasellar Region
title_sort malignant lymphoma in the parasellar region
url http://dx.doi.org/10.1155/2014/747280
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AT hiroyoshiakutsu malignantlymphomaintheparasellarregion
AT shingotakano malignantlymphomaintheparasellarregion
AT tetsuyayamamoto malignantlymphomaintheparasellarregion
AT eiichiishikawa malignantlymphomaintheparasellarregion
AT yasushiokoshi malignantlymphomaintheparasellarregion
AT akiramatsumura malignantlymphomaintheparasellarregion