Primary lymphoma of bone revealed by diabetes insipidus

Introduction, - Diabetes insipidus is a very rare, occasionally misleading, revealing symptom of non Hodgkin's malignant lymphoma. We report a case of this uncommon association and a review of the literature is done. Exegesis, - Soon after a transient attack of diplopia due, to a 6th cranial nerve palsy, idiopathic cerebral diabetes insipidus was diagnosed in a 32- year-old immunocompetent man. As anterior hypopituitarism was absent, the p atient was discharged and treated with desmopressin acetate. Sir months lat er, recurrence of diploplia together with raised erythrocyte sedimentation rate was observed and B cell lymphoma was observed in the iliac bone and sk ull, with extension into the right cavernous sinus. Both tumoral lesions le d to important uptake of gallium-67. After a 26-month follow-rep following intensive chemotherapy including autologous peripheral stem cell transplant ation and local radiotherapy, lymphoma symptoms had disappeared, but the pa tient's condition had only partially improved with regard to diabetes insip idus. The association of lymphoma and diabetes insipidus which has only bee n reported in 14 cases is discussed. Conclusion, - Since endocrine symptoms are often preceding hematological di agnosis, malignant lymphomas should systematically be viewed as potential e tiology of diabetes insipidus. Magnetic resonance imaging which is more sen sitive than computerized tomography in revealing brain lymphomas is mandato ry. Gallium scan imaging might help guide the diagnosis in some instances. (C) 1998 Elsevier, Paris.