ICAM1-Negative Intravascular Large B-Cell Lymphoma of the Pituitary Gland: A Case Report and Literature Review.
AACE Clin Case Rep
; 7(4): 249-255, 2021.
Article
em En
| MEDLINE
| ID: mdl-34307847
ABSTRACT
OBJECTIVE:
Intravascular large B-cell lymphoma (IVLBCL) is a rare and aggressive type of B-cell lymphoma with large cells growing within the lumen of blood vessels. Although previous reports revealed highly variable symptoms resulting from small-vessel occlusion by neoplastic cells in a variety of organs, there are few reports of IVLBCL with pituitary involvement.METHOD:
We present a case of IVLBCL with pituitary infiltration from our institution together with a literature review of similar cases to better understand this rare case of IVLBCL involving the pituitary gland.RESULTS:
Our case and the pertinent literature demonstrated that IVLBCL with pituitary involvement predominantly occurred in women at a mean age of 64 years, and most of them showed panhypopituitarism that was reversible after standard therapy of rituximab-containing chemotherapy with intrathecal methotrexate. Notably, the pituitary biopsy in our case revealed that atypical large B-cells found within blood vessels and the pituitary gland were negative for intercellular adhesion molecule 1. Intercellular adhesion molecule 1-negative lymphoid cells may have contributed to panhypopituitarism by extravasation into the pituitary tissues, which do not have a blood-brain barrier and receive abundant blood flow.CONCLUSION:
IVLBCL of the pituitary gland is a rare lymphoma with nonspecific manifestations and a dismal prognosis. Recognition of the clinicopathological features is necessary for early clinical diagnosis and appropriate treatment.
ACTH, adrenocorticotropic hormone; BAL, bronchoalveolar lavage fluid analysis; CRH, corticotropin-releasing hormone; FDG, 18F-fluorodeoxyglucose; FSH, follicle-stimulating hormone; GH, growth hormone; GHRP2, growth hormone-releasing peptide 2; ICAM1; ICAM1, intercellular adhesion molecule 1; IVLBCL, intravascular large B-cell lymphoma; LDH, lactate dehydrogenase; LH, luteinizing hormone; LHRH, luteinizing hormone-releasing hormone; MEAM, ranimustine, etoposide, cytarabine, and melphalan; MTX, methotrexate; R-CHOP, rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone; R-hyper-CVAD/MA, rituximab plus hyper-fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with methotrexate and cytarabine; TBLB, transbronchial lung biopsy; TRH, thyrotropin-releasing hormone; TSH, thyrotropin; hypopituitarism; intravascular; large B-cell lymphoma; pituitary; sIL2R, soluble IL-2 receptor
Texto completo:
1
Bases de dados:
MEDLINE
Tipo de estudo:
Prognostic_studies
Idioma:
En
Revista:
AACE Clin Case Rep
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Japão