{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:25:19Z","timestamp":1762507519842,"version":"3.44.0"},"reference-count":46,"publisher":"BMJ","funder":[{"name":"Prof. Rom\u00e1n\u2019s research is funded by the Blanton Distinguished Endowed Chair"},{"name":"Blanton-Wareing Family Fund"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,7,26]]},"abstract":"<jats:p>A 37-year-old Hispanic man with a right atrial intracardiac mass diagnosed as diffuse large B-cell lymphoma (DLBCL) was successfully treated with surgery and chemotherapy. During 4 years, several total-body positron emission tomography and MRI scans showed no extracardiac lymphoma. On year 5 after the cardiac surgery, patient presented with sleepiness, hyperphagia, memory loss, confabulation, dementia and diabetes insipidus. Brain MRI showed a single hypothalamic recurrence of the original lymphoma that responded to high-dose methotrexate treatment. Correction of diabetes insipidus improved alertness but amnesia and cognitive deficits persisted, including incapacity to read and write. This case illustrates two unusual locations of DLBCL: primary cardiac lymphoma and hypothalamus. We emphasise the importance of third ventricle tumours as causing amnesia, confabulation, behavioural changes, alexia\u2013agraphia, endocrine disorders and alterations of the circadian rhythm of wakefulness\u2013sleep secondary to lesions of specific hypothalamic nuclei and disruption of hypothalamic\u2013thalamic circuits.<\/jats:p>","DOI":"10.1136\/bcr-2016-217700","type":"journal-article","created":{"date-parts":[[2018,8,27]],"date-time":"2018-08-27T11:10:45Z","timestamp":1535368245000},"page":"bcr-2016-217700","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Hypothalamic relapse of a cardiac large B-cell lymphoma presenting with memory loss, confabulation, alexia\u2013agraphia, apathy, hypersomnia, appetite disturbances and diabetes insipidus"],"prefix":"10.1136","volume":"2018","author":[{"given":"Natalia","family":"Ospina-Garc\u00eda","sequence":"first","affiliation":[{"name":"Department of Neurology, National University of Colombia, Bogota, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo C","family":"Rom\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Neurology, Methodist Neurological Institute, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bel\u00e9n","family":"Pascual","sequence":"additional","affiliation":[{"name":"Department of Neurology, Methodist Neurological Institute, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary R","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Pathology, Houston Methodist Hospital, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hector Alejandro","family":"Preti","sequence":"additional","affiliation":[{"name":"Department of Medicine (Oncology), Houston Methodist Hospital, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,8,27]]},"reference":[{"key":"2025082723582456000_2018.aug27_1.bcr-2016-217700.1","unstructured":"Maleszewski JJ , Jaffe ES . et al Cardiac lymphomas. 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