A Biphasic Presentation of Diffuse Large B-cell Lymphoma Metastasis to the Hypothalamus-pituitary Axis: A Case Report and Literature Review.

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2024-09-09 eCollection Date: 2024-01-01 DOI:10.55729/2000-9666.1393
Fadi Alghzawi, Maria Martinez-Cruz, Salman Z Bhat, Christopher J Haas
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Abstract

The Hypothalamus-Pituitary axis (HPA) is a rare location for metastasis of non-Hodgkin's lymphoma. Lymphomas constitute less than 0.5% of reported HPA metastasis. This case is unique in that, in addition to the noted panhypopituitarism; initial diagnostics demonstrated marked hyponatremia, consistent with syndrome of inappropriate antidiuretic hormone (SIADH), which was subsequently complicated by sudden diabetes insipidus (DI), suggesting hypothalamic/stalk infiltration. Despite low sensitivity, CSF cytology/flow cytometry may serve as a less invasive diagnostic measure. Treatment includes systemic chemotherapy with agents that cross the blood-brain barrier. Surgical resection alone or associated radiotherapy did not show an increase in survival. The prognosis remains poor.

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弥漫大 B 细胞淋巴瘤转移至下丘脑-垂体轴的双相表现:病例报告和文献综述。
下丘脑-垂体轴(HPA)是非霍奇金淋巴瘤转移的罕见部位。淋巴瘤在报告的 HPA 转移中占不到 0.5%。该病例的独特之处在于,除了已发现的泛垂体功能障碍外,初步诊断还显示出明显的低钠血症,与不适当抗利尿激素综合征(SIADH)一致,随后又并发了突发性尿崩症(DI),提示下丘脑/茎突浸润。尽管灵敏度较低,但脑脊液细胞学/流式细胞术可作为一种侵入性较小的诊断方法。治疗包括使用能穿过血脑屏障的药物进行全身化疗。单纯手术切除或配合放疗并不能提高生存率。预后仍然很差。
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发文量
106
审稿时长
17 weeks
期刊介绍: JCHIMP provides: up-to-date information in the field of Internal Medicine to community hospital medical professionals a platform for clinical faculty, residents, and medical students to publish research relevant to community hospital programs. Manuscripts that explore aspects of medicine at community hospitals welcome, including but not limited to: the best practices of community academic programs community hospital-based research opinion and insight from community hospital leadership and faculty the scholarly work of residents and medical students affiliated with community hospitals.
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