Pituitary lymphoma [Neurosurgery Wiki]

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=====Pituitary lymphoma=====
The entity of [[pituitary gland]] (sellar or parasellar) [[lymphoma]] includes primary pituitary lymphoma (PPL) and secondary pituitary lymphoma (SPL). The latter has an involvement of systemic lymphoma. Both of these lymphomas are extremely rare. 

The entity of pituitary lymphoma is extremely rare. Nineteen cases of PPL and 16 cases of SPL have been reported. Generally, clinical and radiological diagnosis was difficult because there are no specific findings. Therefore, biopsy was necessary in all of the cases. T2 [[Hypointensity]] of a lesion in MR imaging in addition to an elevated serum level of soluble interleukin-2 receptor (sIL-2R) in a patient with a sellar lesion can be useful clues for the differential diagnosis of this rare disease
((Koiso T, Akutsu H, Takano S, Yamamoto T, Ishikawa E, Okoshi Y, Matsumura A.
Malignant lymphoma in the parasellar region. Case Rep Med. 2014;2014:747280. doi:
10.1155/2014/747280. Epub 2014 Feb 10. PubMed PMID: 24660002.)).
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In the [[pituitary]] [[sella]], [[collision tumor]]s are exceedingly rare, and not much is known about their etiology and prognosis.

A 74-year-old man presented with a concomitant primary [[pituitary lymphoma]] (diffuse large B-cell non-Hodgkin’s lymphoma; DLBCL) and [[follicle stimulating hormone secreting pituitary neuroendocrine tumor]] diagnosed histologically after clinical features of apoplexy prompted urgent surgical decompression and resection. Strong immunoreactivity for [[FSH]] by the [[lymphoma]] was evident. Full-body workup demonstrated no other source for the lymphoma. He subsequently underwent 4 cycles of [[chemotherapy]] and has been in remission for over 32 months. His [[ophthalmoplegia]] at presentation persisted with no further deficits.

Four cases of [[collision tumor]]s of primary pituitary lymphoma and adenoma have previously been reported. This case represents the first combination of an FSH-adenoma and a DLBCL in the literature. Prompt involvement of the hematology-oncology team contributed to the good outcome seen in this case. The putative role played by pituitary hormones in tumorigenesis is reviewed in this case report. The association is either a chance occurrence or due to the induction of lymphoma cell proliferation by the binding of FSH produced by the adenoma to the FSH receptors on the lymphoma cells
((https://neurosurgerycns.wordpress.com/2016/12/29/advance-access-concomitant-primary-cns-lymphoma-and-fsh-pituitary-adenoma-arising-within-the-sella-entirely-coincidental/)).