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Asymptomatic pituitary macroadenoma oppressing optic chiasm – ‘incidentaloma‘ – identified within diagnostical staging of patient with primary extranodal diffuse large B-cell lymphoma of orbit and paranasal sinuses – a case report


Authors: T. Szotkowski 1;  Z. Fryšák 2;  P. Koranda 3;  E. Čecháková 4
Authors‘ workplace: Hemato-onkologická klinika LF UP Olomouc, 2III. interní klinika – nefrologická, revmatologická a endokrinologická LF UP Olomouc, 3Klinika nukleární medicíny LF UP Olomouc, 4Radiologická klinika LF UP Olomouc 1
Published in: Transfuze Hematol. dnes,18, 2012, No. 1, p. 39-42.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

A case of 63-year-old man with an asymptomatic pituitary expansion found within a staging of a newly diagnosed lymphoma is presented. Histological examination of the right orbit tumour affecting adjoined parts of skeleton and paranasal sinuses determined the diagnosis of diffuse large B-cell lymphoma. However, an expansively enlarged pituitary gland was found at CT scan at the same time. The suspicion of pituitary macroadenoma oppressing optic chiasm was pronounced based on targeted magnetic resonance imaging. The lymhoma became smaller after chemotherapy while the lesion in sella turcica was being unchanged. It was the reason for performing a transsfenoidal extirpation. The diagnosis of pituitary adenoma was really confirmed by histological examination of the surgically gained tissue.

Key words:
adenoma, pituitary incidentaloma, diffuse large B-cell lymphoma, PET/CT, tumour duplicity


Sources

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2. Megan Ogilvie C, Payne S, Evanson J, Lister TA, Grossman AB. Lymphoma metastasizing to the pituitary: an unusual presentation of a treatable disease. Pituitary 2005; 8(2): 139–146.

3. Kenchaiah M, Hyer SL. Diffuse large B-cell non Hodgkin’s lymphoma in a 65-year-old woman presenting with hypopituitarism and recovering after chemotherapy: a case report. Journal of Medical Case Reports 2011, 5: 198.

4. Hayasaka K, Koyama M, Yamashita T. Primary pituitary lymphoma diagnosis by FDG-PET/CT. Clin Nucl Med. 2010, 35(3): 205.

5. Carrasco CA, Rojas ZD, Chiorino R, González G. Primary pituitary lymphoma in immunocompetent patient: diagnostic problems and prolonged follow-up. Pituitary. 2010 Feb 10 [Epub ahead of print].

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7. Papajík T, Mysliveček M, Šedová Z, et al. Synchronous second primary neoplasms detected by initial staging F-18 FDG PET/CT Examination in Patients With Non-Hodgkin Lymphoma. Clin Nucl Med. 2011, 36(7): 509–512.

8. Romeike BF, Joellenbeck B, Stein H, et al. Precursor T-lymphoblastic lymphoma within a recurrent pituitary adenoma. Acta Neurochir (Wien) 2008, 150(8): 833–836.

Labels
Haematology Internal medicine Clinical oncology

Article was published in

Transfusion and Haematology Today

Issue 1

2012 Issue 1

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