[A case of non-Hodgkin lymphoma in the central nervous system, developing during treatment of galactorrhea amenorrhea syndrome].
We report a 27-year-old woman with a non-Hodgkin lymphoma in the central nervous system (CNS), showing monoparesis of the right upper extremity during treatment for the galactorrhea amenorrhea syndrome. The MRI demonstrated an infiltrative lesion with an obvious gadolinium-enhancement effect, extending from the pituitary stalk and hypothalamus through the 4th ventricle to the dorsal part of the medulla and upper cervical spinal cord. Because no tumors were detected in any other organ in either a physical examination or radiological investigations, including CT for the chest and abdomen, she was diagnosed as having primary CNS non-Hodgkin lymphoma (B cell origin) on the basis of an open brain biopsy. After the irradiation of the whole brain, followed by chemotherapy (methotrexate + CHOP), the infiltrative tumor disappeared on the MRI with a slight improvement for monoparesis of the right upper extremity. In this patient, primary CNS lymphoma might originate around the hypothalamus and infiltrate the medulla, inducing not only monoparesis of the right upper extremity but the galactorrhea amenorrhea syndrome.
Matsuda
M
M
Department of Neurology, Saku Central Hospital.
Hattori
T
T
Tabata
K
K
Seki
S
S
D000328:Adult; D000568:Amenorrhea / Q000209:etiology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016543:Central Nervous System Neoplasms / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005687:Galactorrhea / Q000209:etiology*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008727:Methotrexate / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage; D013577:Syndrome; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage; D014916:Whole-Body Irradiation
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone; D008727:Methotrexate