ICAM1-Negative Intravascular Large B-Cell Lymphoma of the Pituitary Gland: A Case Report and Literature Review.

Abstract

OBJECTIVE:

Intravascular large B-cell lymphoma (IVLBCL) is a rare and aggressive type of B-cell lymphoma with large cells growing within the lumen of blood vessels. Although previous reports revealed highly variable symptoms resulting from small-vessel occlusion by neoplastic cells in a variety of organs, there are few reports of IVLBCL with pituitary involvement.

METHOD:

We present a case of IVLBCL with pituitary infiltration from our institution together with a literature review of similar cases to better understand this rare case of IVLBCL involving the pituitary gland.

RESULTS:

Our case and the pertinent literature demonstrated that IVLBCL with pituitary involvement predominantly occurred in women at a mean age of 64 years, and most of them showed panhypopituitarism that was reversible after standard therapy of rituximab-containing chemotherapy with intrathecal methotrexate. Notably, the pituitary biopsy in our case revealed that atypical large B-cells found within blood vessels and the pituitary gland were negative for intercellular adhesion molecule 1. Intercellular adhesion molecule 1-negative lymphoid cells may have contributed to panhypopituitarism by extravasation into the pituitary tissues, which do not have a blood-brain barrier and receive abundant blood flow.

CONCLUSION:

IVLBCL of the pituitary gland is a rare lymphoma with nonspecific manifestations and a dismal prognosis. Recognition of the clinicopathological features is necessary for early clinical diagnosis and appropriate treatment.

• Authors: Kumiko Naito, Sawako Suzuki, Chikako Ohwada, Kazuki Ishiwata, Yutaro Ruike, Akiko Ishida, Hanna Deguchi-Horiuchi, Masanori Fujimoto, Hisashi Koide, Emiko Sakaida, Kentaro Horiguchi, Yasuo Iwadate, Ichiro Tatsuno, Naoko Inoshita, Jun-Ichiro Ikeda, Tomoaki Tanaka, Koutaro Yokote
• Journal: AACE clinical case reports (AACE Clin Case Rep) 2021 Jul-Aug Vol. 7 Issue 4 Pg. 249-255 ISSN: 2376-0605 [Electronic] United States
• PMID: 34307847 (Publication Type: Case Reports)
• Copyright: © 2021 AACE. Published by Elsevier Inc.