<abstract xmlns="http://www.w3.org/1999/xhtml"> Background: Primary central nervous system lymphoma (PCNSL) involving the hypothalamus and pituitary gland is extremely rare. Therefore, no case to our knowledge has been reported to date.Objective: We described our findings in a 48-year-old immunocompetent man, who presented with four months progressive diabetes insipidus (DI) and two months subsequent headache.Methods and Results: A radiological study and magnetic resonance imaging (MRI) suggested a homogeneous enhancing dumbbell-shaped lesion, 2.4⃞1.2 cm in size, involving both the hypothalamus and pituitary gland. A brain biopsy was conducted through a transnasal transsphenoidal approach, and a final histopathological diagnosis of the tumor was confirmed as diffuse large B-cell malignant lymphoma. After extensive tumor surveys, including computed tomography, MRI, ultrasound, bone marrow biopsy, lumbar puncture, and positron emission tomography (PET), no evidence of other lesions found. Subsequently, he received six cycles of intravenous highdose methotrexate-based chemotherapy followed by one cycle of whole-brain radiotherapy. The progressive DI and headache completely resolved and he was in good health 11 months later.Conclusion: Clinicians should consider the possibility of PCNSL in non specific clinical presentations. </abstract>

Background: Primary central nervous system lymphoma (PCNSL) involving the hypothalamus and pituitary gland is extremely rare. Therefore, no case to our knowledge has been reported to date.Objective: We described our findings in a 48-year-old immunocompetent man, who presented with four months progressive diabetes insipidus (DI) and two months subsequent headache.Methods and Results: A radiological study and magnetic resonance imaging (MRI) suggested a homogeneous enhancing dumbbell-shaped lesion, 2.4⃞1.2 cm in size, involving both the hypothalamus and pituitary gland. A brain biopsy was conducted through a transnasal transsphenoidal approach, and a final histopathological diagnosis of the tumor was confirmed as diffuse large B-cell malignant lymphoma. After extensive tumor surveys, including computed tomography, MRI, ultrasound, bone marrow biopsy, lumbar puncture, and positron emission tomography (PET), no evidence of other lesions found. Subsequently, he received six cycles of intravenous highdose methotrexate-based chemotherapy followed by one cycle of whole-brain radiotherapy. The progressive DI and headache completely resolved and he was in good health 11 months later.Conclusion: Clinicians should consider the possibility of PCNSL in non specific clinical presentations.

Dumbbell-shaped primary CNS lymphoma involving the hypothalamus and pituitary gland

Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003,

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Background: Primary central nervous system lymphoma (PCNSL) involving the hypothalamus and pituitary gland is extremely rare. Therefore, no case to our...

Dumbbell-shaped primary CNS lymphoma involving the hypothalamus and pituitary gland

Article Category: Clinical report

Published Online: Feb 04, 2017

Page range: 481 - 485

DOI: https://doi.org/10.5372/1905-7415.0603.080

Keywords
CD20, dumbbell-shaped, methotrexate, primary central nervous system lymphoma, whole-brain radiotherapy

© 2017

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Dumbbell-shaped primary CNS lymphoma involving the hypothalamus and pituitary gland

Article Category: Clinical report

Published Online: Feb 04, 2017

Page range: 481 - 485

DOI: https://doi.org/10.5372/1905-7415.0603.080

KeywordsCD20, dumbbell-shaped, methotrexate, primary central nervous system lymphoma, whole-brain radiotherapy

© 2017

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
CD20, dumbbell-shaped, methotrexate, primary central nervous system lymphoma, whole-brain radiotherapy