PRIMARY LYMPHOMA OF PITUITARY-GLAND - A NEOPLASM OF ACQUIRED MALT

A 66-yr-old man presented with presyncopal episodes, dizziness, anorex ia, nausea, and weight loss and was noted to have low blood pressure w ith a postural drop and sparse eyebrows. Laboratory investigations rev ealed evidence of hypopituitarism. Magnetic resonance imaging (MRI) re vealed a non-enhancing mass arising from the adenohypophysis. The neur ohypophysis was displaced laterally but appeared otherwise normal. The lesion was thought to be a nonfunctioning pituitary adenoma and a tra ns-sphenoidal hypophysectomy was performed. Histologically, this lesio n was a diffuse large B-cell lymphoma that had features of a high grad e mucosa associated lymphoid tissue (MALT)-type lymphoma arising in as sociation with low-grade B-cell lymphoma of MALT type. There was no cl inical or radiological evidence of lymphoma in other sites and there w as no evidence of an immunocompromised state. Only one previous case o f primary malignant lymphoma of the pituitary has been reported and th is patient presented with compression of the optic chiasm. We describe the clinical and pathological features of a patient who presented wit h hypopituitarism and was found to have a pituitary lymphoma. This is the first reported case of a pituitary lymphoma presenting with pituit ary failure and the first case characterized by lymphocyte-marker stud ies that confirmed it to be a B-cell lymphoma.