ABSTRACT
BACKGROUND: Primary central nervous system lymphoma is a rare extra-nodal lymphoma of the central nervous system. Primary central nervous system lymphoma lesions usually appear in the vicinity of the ventricle, and there are few reports of primary central nervous system lymphoma with hypothalamic-pituitary lesions. CASE PRESENTATION: We treated a 56-year-old male with primary central nervous system lymphoma with the primary lesion in the hypothalamus, which was found by magnetic resonance imaging after sudden onset of endocrinological abnormalities. Initially, he was hospitalized to our department for hyponatremia. Endocrinological examination in conjunction with head magnetic resonance imaging and endoscopic biopsy revealed hypothalamic hypopituitarism and tertiary hypoadrenocorticism caused by a rapidly growing, diffuse large B-cell lymphoma in the hypothalamus. Remission of the tumor was achieved by high-dose methotrexate with whole brain radiotherapy, and some of the hormone responses were normalized. CONCLUSIONS: While primary central nervous system lymphoma is rare, it is important to note that hypopituitarism can result and that the endocrinological abnormalities can be partially restored by its remission.
Subject(s)
Central Nervous System Neoplasms/diagnosis , Central Nervous System Neoplasms/therapy , Hypothalamic Neoplasms/diagnosis , Hypothalamic Neoplasms/therapy , Lymphoma, Large B-Cell, Diffuse/diagnosis , Lymphoma, Large B-Cell, Diffuse/therapy , Adrenal Cortex Hormones/deficiency , Antimetabolites, Antineoplastic/therapeutic use , Chemoradiotherapy , Combined Modality Therapy , Endocrine System Diseases/etiology , Hormone Replacement Therapy , Humans , Hypopituitarism/etiology , Magnetic Resonance Imaging , Male , Methotrexate/therapeutic use , Middle Aged , Treatment OutcomeABSTRACT
Gram-negative bacteria communicate with one another using N-acylhomoserine lactones (AHLs) as signaling molecules. This mechanism, known as quorum sensing (QS), is needed to develop pathogenicity, as well as symbiotic interactions with eukaryotic hosts, such as animals and plants. Increasing evidence indicates that certain bacteria, namely endobacteria, also inhabit fungal cells and establish symbiotic relationships with their hosts. However, it has not been clear whether bacterial QS acts in developing the relationships. Here we describe the isolation and identification of N-heptanoylhomoserine lactone and N-octanoylhomoserine lactone from the culture broth of the zygomycete fungus Mortierella alpina A-178. This suggested the presence of endobacteria in the fungus, as was confirmed by PCR, fluorescence in situ hybridization, and transmission electron microscopy. Two major bands obtained by PCR-denaturing gradient gel electrophoresis showed sequence identity to genes in the ß-proteobacterium Castellaniella defragrans (100 %) and the Gram-positive bacterium Cryobacterium sp. (99.8 %). The production of AHLs depended on the presence of endobacteria and was induced in response to the increase in the concentration of AHLs, suggesting that the bacterium conducts AHL-mediated QS in the fungus. This paper is the first to report the production of AHLs by endofungal bacteria and raises the possibility that QS plays roles in the development of fungus-endobacterium symbiosis.
Subject(s)
4-Butyrolactone/analogs & derivatives , Bacterial Proteins/metabolism , Gram-Negative Bacteria/metabolism , Homoserine/analogs & derivatives , Mortierella/physiology , Quorum Sensing/physiology , 4-Butyrolactone/biosynthesis , 4-Butyrolactone/metabolism , Bacterial Proteins/genetics , Base Sequence , Betaproteobacteria/genetics , Betaproteobacteria/metabolism , Gram-Negative Bacteria/genetics , Gram-Positive Bacteria/genetics , Gram-Positive Bacteria/metabolism , Homoserine/biosynthesis , Homoserine/metabolism , In Situ Hybridization, Fluorescence , Lactones , Microscopy, Electron, Transmission , Molecular Sequence Data , Polymerase Chain Reaction , Sequence Homology, Nucleic Acid , SymbiosisABSTRACT
N-Acylhomoserine lactones (AHLs) are widely conserved signal molecules that mediate quorum sensing in Gram-negative bacteria. In this study, deuterium-labeled AHLs were prepared for use as internal standards for isotope dilution mass spectrometry. Their utility in the sensitive and precise quantification of AHLs in culture supernatants of bacteria by GC/MS was demonstrated.
