Pituitary lymphoma

Dr Henry Knipe and Assoc Prof Frank Gaillard et al.

Pituitary lymphoma is very rare, although lymphomatous (or leukemic) infiltration of the perisellar dura is not infrequently encountered as part of more widespread CNS disease. This article concerns itself with involvement of the pituitary itself rather than the region more broadly. For a general discussion please refer to primary CNS lymphoma.

As is the case with CNS lymphoma elsewhere, pituitary lymphomas can either be primary (no systemic disease) or secondary (involvement of the pituitary gland is part of systemic disease). 

Pituitary lymphoma (i.e. parenchymal disease limited to the pituitary gland rather than dural involvement, or extension of cerebral primary CNS lymphoma to the region) is very rare, accounting for 0.1-0.3% of pituitary tumors 1. True primary lymphoma of the CNS is even less common, with only a smattering of cases reported 1-3

Pituitary function is usually not impaired, and lymphoma of the pituitary is usually identified either incidentally or as the result of increased uptake when imaging the whole body.  Occasionally patients present as a result of the syndrome of inappropriate antidiuretic hormone (SIADH) 2. Rarely the tumor is large enough to cause mass effect upon the optic chiasm 2.  

As is the case with primary CNS lymphoma, the majority of primary pituitary lymphomas are non-Hodgkin B-cell lymphomas 1-3

As is the case with other pituitary region masses, MRI is the modality of choice for evaluation of suspected pituitary lymphoma.

Lymphomatous masses share similar signal intensity irrespective of their location, influenced by the tightly packed cellularity of these tumor and high nucleus-to-cytoplasm ratio of lymphoma 3. They appear as solid masses. 

  • T1: iso- to hypointense
  • T2: iso-to hypointense
  • T1 C+:
    • vivid contrast enhancement
    • may be heterogeneous even in immunocompetent hosts (unlike cerebral lymphoma)

The differential is primarily that of solid and enhancing  pituitary region masses, with the main differentials being:


Article information

rID: 17942
Synonyms or Alternate Spellings:
  • Lymphoma of the pituitary

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Cases and figures

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