Document Detail


Panhypopituitarism as an initial manifestation of primary central nervous system non-Hodgkin's lymphoma.
MedLine Citation:
PMID:  14561574     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report an unusual case of primary central nervous system non-Hodgkin's lymphoma in which the initial manifestation was panhypopituitarism. METHODS: We present a retrospective case review and discuss similar cases from the literature. RESULTS: A 64-year-old woman with nausea, vomiting, diarrhea, and peripheral and periorbital edema was found to have panhypopituitarism. Magnetic resonance imaging showed minimal enlargement of the pituitary, and a transsphenoidal biopsy of the pituitary was nondiagnostic. Months later, abnormalities of extraocular movements developed. Repeated imaging and a second transsphe-noidal biopsy did not reveal the ultimate diagnosis. When further neurologic signs and symptoms subsequently developed, a right temporal open craniotomy was performed. It was not until this procedure, the patient's third biopsy, that the cause of her illness was discovered to be diffuse large cell lymphoma. CONCLUSION: Although idiopathic panhypopituitarism is a relatively common clinical entity, it remains a diagnosis of exclusion. The development of associated neurologic signs should prompt the clinician to initiate a new search for an underlying cause. This case underscores the protean manifestations of central nervous system lymphoma, both endocrine and neurologic, and the difficulties that may be encountered in attempts to establish a diagnosis.
Authors:
Bradley J Katz; Robert E Jones; Kathleen B Digre; Judith E A Warner; Kevin R Moore
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  9     ISSN:  1530-891X     ISO Abbreviation:  Endocr Pract     Publication Date:    2003 Jul-Aug
Date Detail:
Created Date:  2003-10-16     Completed Date:  2004-04-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  296-300     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology and Visual Sciences and John A. Moran Eye Center, University of Utah Health Sciences Center, Salt Lake City, Utah 84132, USA.
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MeSH Terms
Descriptor/Qualifier:
Abducens Nerve Diseases / etiology
Aged
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Botulinum Toxins / therapeutic use
Central Nervous System Neoplasms / complications*,  drug therapy,  pathology,  radionuclide imaging
Fatal Outcome
Female
Headache / etiology
Humans
Hypopituitarism / etiology*,  pathology,  radionuclide imaging
Lymphoma, Non-Hodgkin / complications*,  drug therapy,  pathology
Magnetic Resonance Imaging
Nausea / etiology
Vomiting / etiology
Chemical
Reg. No./Substance:
0/Botulinum Toxins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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