[Primary Pituitary Malignant Lymphoma that was Difficult to Differentiate from Nonfunctioning Pituitary Adenoma:A Case Report].

We report a rare case of primary pituitary lymphoma in a 75-year-old immunocompetent woman. The patient was blind in the right eye and presented with visual disturbance in the left eye that started 2 months previously. She also exhibited right third and fifth cranial nerve palsy. Magnetic resonance imaging(MRI)revealed an intrasellar mass lesion with right cavernous sinus invasion and suprasellar extension with compression of the optic chiasm. The mass lesion was isointense on both T1WI and T2WI, and showed less enhancement than a normal pituitary gland on gadolinium-enhanced T1WI. We therefore suspected the tumor to be a nonfunctioning pituitary adenoma. The patient underwent endoscopic endonasal transsphenoidal surgery. The tumor was firm and grayish, and had an ill-defined border along the normal pituitary gland. Histological examination revealed a malignant CD5-positive diffuse large B-cell lymphoma. After surgery, the patient received both chemotherapy and radiotherapy. Although the visual acuity of the right eye did not improved, other symptoms improved. At the 34-month follow-up, no recurrence was detected on serial MRI. Patients with primary pituitary lymphoma often exhibit ophthalmoplegia and/or panhypopituitarism more frequently than expected from radiological findings. In cases of pituitary tumors with atypical symptoms, a biopsy and general physical examination should be performed immediately to determine the diagnosis and perform adjuvant therapy even when the tumor is assumed as nonfunctioning pituitary adenoma from the image findings.

Replacing white rice with pre-germinated brown rice mildly ameliorates hyperglycemia and imbalance of adipocytokine levels in type 2 diabetes model rats.

Pre-germinated brown rice (PR) has been developed industrially in order to enhance the nutritional functions of its source material, brown rice (BR). The present study was aimed at clarifying the effect of PR on the type 2 diabetes mellitus. We employed Otsuka Long-Evans Tokushima Fatty (OLETF) rats as a model of type-2 diabetes mellitus. OLETF rats were fed on either PR or white rice (WR) from the age of 4 to 35 wk. Age-matched male Long-Evans Tokushima Otsuka (LETO) rats as a non-diabetic control were also fed on WR. The HbA(1c) level in OLETF rats was significantly higher than that in LETO rats. However, the level was lower in PR-fed OLETF rats than in WR-fed OLETF rats. The plasma concentrations of TNF-α and PAI-1 in OLETF rats were higher than those in LETO rats. However, both elevated levels were decreased by the PR-feeding, but not by the WR-feeding. On the other hand, the plasma adiponectin concentration in OLETF rats was lower than that in LETO rats. The decrease in adiponectin level of OLETF rats was ameliorated by PR-feeding. The size of adipocytes in PR-fed OLETF rats was smaller than that in WR-fed OLETF rats. In summary, intake of PR instead of WR ameliorates both insulin resistance and imbalance of the levels of plasma adipocytokines leading to diabetic complications.