Intravascular large B-cell lymphoma arising in the pituitary gland: A case report

Medicine (Baltimore). 2024 Dec 13;103(50):e40995. doi: 10.1097/MD.0000000000040995.

Abstract

Rationale: Primary pituitary lymphoma is defined as a lymphoma that develops only in the pituitary gland without involvement of other areas.

Patient concerns: We present the case of a 61-year-old female patient who underwent an endonasal transsphenoidal approach for the preoperative diagnosis of a pituitary macroadenoma based on radiological findings.

Diagnoses: Microscopically, the capillaries were distended by tumor cells. The high-magnification view showed large cells with vesicular nuclei and single or multiple prominent nucleoli, with mitotic figures often observed within the intravascular space.

Interventions: Immunohistochemical staining showed strong positivity for CD45 and pan-B cell markers such as CD19 and CD20. The postoperative diagnosis was intravascular large B-cell lymphoma of the pituitary gland.

Outcomes: Next-generation sequencing revealed alterations in 12 genes: ARID5B, BCL2, CD79B, ETV6, HLA-B, LRRC7, MYD88, PIM1, POT1, PTPN11, RASA1, and SRSF2.

Lessons: To our knowledge, this is the first case report of pituitary intravascular large B-cell lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / genetics
  • Adenoma / pathology
  • Adenoma / surgery
  • Female
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / diagnosis
  • Lymphoma, Large B-Cell, Diffuse* / genetics
  • Lymphoma, Large B-Cell, Diffuse* / pathology
  • Middle Aged
  • Pituitary Gland / pathology
  • Pituitary Neoplasms* / diagnosis
  • Pituitary Neoplasms* / genetics
  • Pituitary Neoplasms* / pathology
  • Vascular Neoplasms / diagnosis
  • Vascular Neoplasms / pathology