{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:13:01Z","timestamp":1789560781282,"version":"build-2803163510"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 2","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Primary hypothalamic involvement in primary central nervous system lymphoma is rare and can present with nonspecific neurological and endocrine manifestations, resulting in significant diagnostic delays. We report the case of an immunocompetent 29-year-old female who presented with intermittent fever, seizures, progressive behavioral changes, central diabetes insipidus, and hypopituitarism. She was initially treated empirically for encephalitis with anti-epileptics and corticosteroids. Neuroimaging subsequently demonstrated a homogeneously enhancing lesion along the chiasmatic\u2013hypothalamic axis. Initial biopsy was nondiagnostic due to corticosteroid pretreatment, necessitating repeat biopsy via craniotomy, which confirmed diffuse large B-cell lymphoma. This case illustrates the importance of recognizing endocrine red flags in hypothalamic lesions, emphasizes the negative impact of prebiopsy steroid exposure on diagnostic yield, obscuring histopathology even in the absence of radiological regression.<\/jats:p>","DOI":"10.4103\/aam.aam_188_26","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T12:00:59Z","timestamp":1775736059000},"page":"S427-S430","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Primary Central Nervous System Lymphoma with Central Diabetes Insipidus and Hypopituitarism: Diagnostic Pitfalls in the \u201cGhost Tumor\u201d with Steroid-induced Lymphocytolysis"],"prefix":"10.4103","volume":"25","author":[{"given":"Tushar","family":"Kalekar","sequence":"first","affiliation":[{"name":"Department of Radio-Diagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihir","family":"Wadhawan","sequence":"additional","affiliation":[{"name":"Department of Radio-Diagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambika","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Radio-Diagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"R1-20260916","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.critrevonc.2007.04.012","article-title":"Primary central nervous system lymphoma","volume":"63","author":"Ferreri","year":"2007","journal-title":"Crit Rev Oncol Hematol"},{"key":"R2-20260916","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.3892\/ol.2013.1266","article-title":"Clinical features of patients with non-Hodgkin's lymphoma metastasizing to the pituitary glands","volume":"5","author":"Yang","year":"2013","journal-title":"Oncol Lett"},{"key":"R3-20260916","doi-asserted-by":"crossref","first-page":"174","DOI":"10.3171\/jns.1984.60.1.0174","article-title":"Primary cerebral lymphoma: The \"ghost tumor\". Case report","volume":"60","author":"Vaquero","year":"1984","journal-title":"J Neurosurg"},{"key":"R4-20260916","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1212\/WNL.59.5.762","article-title":"Is a \"vanishing tumor\" always a lymphoma?","volume":"59","author":"Bromberg","year":"2002","journal-title":"Neurology"},{"key":"R5-20260916","doi-asserted-by":"crossref","first-page":"e29637","DOI":"10.1097\/MD.0000000000029637","article-title":"Steroid-induced delayed diagnosis of primary vitreoretinal lymphoma with ghost brain tumor: A case report","volume":"101","author":"Kau","year":"2022","journal-title":"Medicine (Baltimore)"},{"key":"R6-20260916","doi-asserted-by":"crossref","DOI":"10.1016\/j.annonc.2023.11.010","article-title":"Primary central nervous system lymphomas: EHA-ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","author":"Ferreri","year":"2024","journal-title":"Ann Oncol"},{"key":"R7-20260916","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1186\/s13256-021-02866-7","article-title":"Primary hypothalamic lymphoma with clinical findings mimicking pituitary apoplexy: A case report","volume":"15","author":"S\u00f6zen","year":"2021","journal-title":"J Med Case Rep"},{"key":"R8-20260916","doi-asserted-by":"crossref","first-page":"984","DOI":"10.3174\/ajnr.A2171","article-title":"Central nervous system lymphoma: Characteristic findings on traditional and advanced imaging","volume":"32","author":"Haldorsen","year":"2011","journal-title":"Am J Neuroradiol"},{"key":"R9-20260916","doi-asserted-by":"crossref","first-page":"260","DOI":"10.3803\/jkes.2008.23.4.260","article-title":"A case of panhypopituitarism and central diabetes insipidus caused by primary central nervous system lymphoma","volume":"23","author":"Ahn","year":"2008","journal-title":"Journal of Korean Endocrine Society"},{"key":"R10-20260916","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1348\/174866407X214172","article-title":"Structure and function in acquired prosopagnosia: Lessons from a series of 10 patients with brain damage","volume":"2","author":"Barton","year":"2008","journal-title":"J Neuropsychol"}],"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_188_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:00:52Z","timestamp":1789560052000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_188_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,10]]},"references-count":10,"journal-issue":{"issue":"Suppl 2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/aam.aam_188_26","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,10]]},"assertion":[{"value":"2026-02-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-16","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}