Primary central nervous system lymphoma mimicking pituitary apoplexy

Case report

Stacey Quintero Wolfe, Brian Hood, Jennifer Barker, Ronald Benveniste

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Lymphoma involving the pituitary gland is very rare and usually results from metastatic spread of systemic lymphoma. We present a case of primary central nervous system (CNS) large B cell lymphoma that manifested as pituitary apoplexy. A 45-year-old woman presented with headache, and then rapidly developed a third nerve palsy and bitemporal hemianopsia. Imaging suggested a pituitary macroadenoma, with spontaneous necrosis, extending into the suprasellar region, compressing the optic chiasm and invading the right cavernous sinus. The patient underwent transsphenoidal resection which revealed a vascular, firm tumor. An aggressive decompression of the optic chiasm was performed with complete resolution of both visual fields and third nerve palsy. Final pathology showed B cell lymphoma. Systemic work-up including bone marrow aspiration and CSF studies showed no other foci of lymphoma, and the patient was HIV-negative. Chemotherapy with methotrexate, vincristine, procarbazine, and dexamethasone was administered for primary CNS lymphoma. This is an uncommon diagnosis of which the clinician should be aware in order to tailor surgical intervention and provide early institution of proper therapy.

Original languageEnglish
Pages (from-to)76-79
Number of pages4
JournalPituitary
Volume12
Issue number1
DOIs
StatePublished - Jan 1 2009

Fingerprint

Pituitary Apoplexy
Lymphoma
Central Nervous System
Oculomotor Nerve Diseases
Optic Chiasm
B-Cell Lymphoma
Procarbazine
Hemianopsia
Cavernous Sinus
Vincristine
Pituitary Gland
Decompression
Visual Fields
Methotrexate
Dexamethasone
Blood Vessels
Headache
Necrosis
Bone Marrow
HIV

Keywords

  • Apoplexy
  • Pituitary
  • Primary central nervous system lymphoma

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Primary central nervous system lymphoma mimicking pituitary apoplexy : Case report. / Quintero Wolfe, Stacey; Hood, Brian; Barker, Jennifer; Benveniste, Ronald.

In: Pituitary, Vol. 12, No. 1, 01.01.2009, p. 76-79.

Research output: Contribution to journalArticle

Quintero Wolfe, Stacey ; Hood, Brian ; Barker, Jennifer ; Benveniste, Ronald. / Primary central nervous system lymphoma mimicking pituitary apoplexy : Case report. In: Pituitary. 2009 ; Vol. 12, No. 1. pp. 76-79.
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