Vol 57, No 6 (2006)
Case report
Published online: 2006-11-29
Diffuse malignant lymphoma type B with optic chiasm infiltration, visual disturbances, hypopituitarism, hyperprolactinaemia and diabetes insipidus. Case report and literature review
Endokrynol Pol 2006;57(6):642-647.
Abstract
The case is reported of a 55-year-old man with diffuse malignant
lymphoma type B associated with transient optic
chiasm infiltration and visual disturbances but with persistent
hypopituitarism, hyperprolactinaemia and diabetes
insipidus. The patient was administered chemotherapy and
radiotherapy. Repeated MR and CT scans showed optic
chiasm infiltration, which disappeared in the course of the
chemotherapy but then recurred, changed its appearance
and finally disappeared again. In the meantime visual disturbances
occurred and disappeared during the therapy.
Hypopituitarism, diabetes insipidus and hyperprolactinaemia
were diagnosed and replacement therapy was administered.
Later on abdominal pain occurred, and a CT scan
revealed bilateral kidney masses and enlarged retroperitoneal
lymph nodes. These were diffuse malignant lymphoma
with regional lymphonodulitis in histology. Finally,
hydrothorax and hydroretroperitoneum were diagnosed.
The patient died as a result of systemic complications of the disease. The length of survival time documented following
the hypothalamochiasmatic infiltration and diagnosis of
lymphoma makes the case an unusual one for patients with
CNS lymphoma. Hormonal disturbances accompanying the
suprasellar region infiltration are very important from the
practical point of view.
Keywords: lymphomahypopituitarismhyperprolactinaemiadiabetes insipidusvisual disturbances
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