The entity of pituitary (sellar or parasellar) lymphoma includes primary pituitary lymphoma (PPL) and secondary pituitary lymphoma (SPL). The latter has an involvement of systemic lymphoma. Both of these lymphomas are extremely rare. We describe a patient with SPL showing a good prognosis. A 78-year-old woman presented with diplopia, left ptosis, and back pain. Magnetic resonance (MR) imaging revealed a parasellar mass lesion extending to the upper clivus and another mass lesion with compression fracture of the Th3 vertebral body. Transsphenoidal exploration was performed, and it showed diffuse large B-cell lymphoma. Based on the positive tumor cells in the following bone marrow aspiration and hepatosplenomegaly in computed tomography (CT) findings, this patient was diagnosed as having a pituitary involvement of systemic lymphoma. After chemotherapy, she achieved complete remission for 4 years. The entity of pituitary lymphoma is extremely rare. Nineteen cases of PPL and 16 cases of SPL have been reported. Generally, clinical and radiological diagnosis was difficult because there are no specific findings. Therefore, biopsy was necessary in all of the cases. T2 hypointensity of a lesion in MR imaging in addition to an elevated serum level of soluble interleukin-2 receptor (sIL-2R) in a patient with a sellar lesion can be useful clues for the differential diagnosis of this rare disease. 1. Introduction According to previous reports, the entity of pituitary (sellar or parasellar) lymphoma includes primary pituitary lymphoma (PPL) and secondary pituitary lymphoma (SPL). SPL includes the involvement of systemic lymphoma. Both of these lymphomas are extremely rare. Nineteen cases of PPL [1–17] and 16 cases of SPL [13, 18–30] have been reported. We describe a patient with SPL treated with chemotherapy following transnasal biopsy and showing a good prognosis. 2. Case Description A 78-year-old woman with no remarkable medical history presented with diplopia, left ptosis, and back pain that has persisted for over one month. Her ocular motility improved spontaneously, but 3 months later, fever, polyuria, and polydipsia appeared. Her body temperature rose to between 38° and 39°C every night. Her urinary volume was 4-5？L/day. There was no weight loss or neurological abnormality. So she went to general hospital and performed brain and thoracic magnetic resonance (MR) imaging. These images showed double lesion at sellar region and Th3 vertebral body. Then, she was admitted to our hospital. Laboratory studies showed anemia and a slight elevation of the serum levels of
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