Hypothalamic-Pituitary Axis Involvement in Primary Central Nervous System Lymphoma: A Systematic Review.
메타분석
1/5 보강
[CONTEXT] Primary central nervous system lymphoma (PCNSL) is a rare malignancy that may involve the hypothalamic-pituitary axis (HPA), leading to underrecognized but clinically significant endocrine d
- p-value p < 0.001
- 95% CI 3.76-23.86
- OR 9.47
APA
Sager-La Ganga C, Navas-Moreno V, et al. (2025). Hypothalamic-Pituitary Axis Involvement in Primary Central Nervous System Lymphoma: A Systematic Review.. The Journal of clinical endocrinology and metabolism. https://doi.org/10.1210/clinem/dgaf620
MLA
Sager-La Ganga C, et al.. "Hypothalamic-Pituitary Axis Involvement in Primary Central Nervous System Lymphoma: A Systematic Review.." The Journal of clinical endocrinology and metabolism, 2025.
PMID
41230877
Abstract
[CONTEXT] Primary central nervous system lymphoma (PCNSL) is a rare malignancy that may involve the hypothalamic-pituitary axis (HPA), leading to underrecognized but clinically significant endocrine dysfunction.
[OBJECTIVE] To characterize the spectrum and patterns of HPA-related endocrine disturbances in patients with PCNSL.
[DATA SOURCES] A systematic search was conducted in PubMed, EMBASE, Scopus, and Web of Science, supplemented by grey literature. The search concluded in February 2025.
[STUDY SELECTION] We included studies reporting adult PCNSL cases with documented dysfunction of at least one hormonal axis. Exclusion criteria were pre-existing hypopituitarism or lack of endocrine data.
[DATA EXTRACTION] Data on demographics, tumor localization, hormonal axes affected, radiological findings, treatment, and outcomes were extracted. Risk of bias was assessed using JBI tools.
[RESULTS] Ninety-nine cases met inclusion criteria. Diffuse large B-cell lymphoma (DLBCL) accounted for 84% of cases. Endocrine dysfunction included isolated adenohypophyseal involvement (46%), neurohypophyseal (8%), and combined (45%). The most affected pituitary axes were the gonadal and thyroid axes, with 89.7% and 89.2% involvement, respectively. Hypothalamic tumors were strongly associated with combined dysfunction (OR = 9.47, 95% CI: 3.76-23.86 p < 0.001). Persistent endocrinopathy was more frequent in progressive disease. No direct association was found between endocrine dysfunction and mortality.
[CONCLUSIONS] HPA dysfunction in PCNSL is frequent and often underdiagnosed. Hypothalamic involvement is associated broader hormonal impairment. Routine hormonal screening and multidisciplinary management should be standard in PCNSL care to minimize complications and improve outcomes.
[OBJECTIVE] To characterize the spectrum and patterns of HPA-related endocrine disturbances in patients with PCNSL.
[DATA SOURCES] A systematic search was conducted in PubMed, EMBASE, Scopus, and Web of Science, supplemented by grey literature. The search concluded in February 2025.
[STUDY SELECTION] We included studies reporting adult PCNSL cases with documented dysfunction of at least one hormonal axis. Exclusion criteria were pre-existing hypopituitarism or lack of endocrine data.
[DATA EXTRACTION] Data on demographics, tumor localization, hormonal axes affected, radiological findings, treatment, and outcomes were extracted. Risk of bias was assessed using JBI tools.
[RESULTS] Ninety-nine cases met inclusion criteria. Diffuse large B-cell lymphoma (DLBCL) accounted for 84% of cases. Endocrine dysfunction included isolated adenohypophyseal involvement (46%), neurohypophyseal (8%), and combined (45%). The most affected pituitary axes were the gonadal and thyroid axes, with 89.7% and 89.2% involvement, respectively. Hypothalamic tumors were strongly associated with combined dysfunction (OR = 9.47, 95% CI: 3.76-23.86 p < 0.001). Persistent endocrinopathy was more frequent in progressive disease. No direct association was found between endocrine dysfunction and mortality.
[CONCLUSIONS] HPA dysfunction in PCNSL is frequent and often underdiagnosed. Hypothalamic involvement is associated broader hormonal impairment. Routine hormonal screening and multidisciplinary management should be standard in PCNSL care to minimize complications and improve outcomes.