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A 21-year-old man was hospitalized with complaints of headache, nausea, polyuria, reduced body hair and reduced libido. Plain CT scan and MRI revealed multiple tumors in the pineal and suprasellar regions, and in the dorsal aspect of the medulla oblongata. Endocrinological examination showed hypopituitarism due to hypothalamic dysfunction. Replacement therapy with hydrocortisone was started preoperatively. Suprasellar tumor was explored. Postoperative CT scan and MRI showed marked diminishment of not only suprasellar tumor, but also tumors in the two other regions. These tumors were supposed to be sensitive to corticosteroid hormone. Histopathological diagnosis was T cell type malignant lymphoma. The patient was followed up for 10 months post-operatively with no recurrence on CT scan. Primary intracranial malignant lymphoma is not a rare disease today. However, primary intracranial T cell type lymphoma is extremely rare. Hypopituitarism due to suprasellar malignant lymphoma is also rare, and only 3 such cases have been reported previously. In our case, the tumor was located in the pineal and suprasellar regions, and the dorsal aspect of the medulla oblongata. Such disseminated malignant lymphoma as ours shows radiological resemblance to germ cell tumor. No such diseminated malignant lymphoma has been reported previously. We think that, in its radiological and clinical features, our case is very suggestive of primary intracranial malignant lymphoma.

A 28-year-old woman was hospitalized in drowsy state with signs of increased intracranial pressure. CT scans revealed diffuse increased density with marked enhancement in the subarachnoid space, as well as ventricular dilatation. V-P shunt operation was performed to control intracranial pressure. Repeated cytological examinations of CSF couldn't determine the tumor origin. CT scan of thoracic spine showed a cystic tumor in its dorsal aspect. T2-weighted MRI revealed multiple spotty low intensity, specific to melanin granules, throughout the whole spine. Her thoracic spine was explored, and the intradural tumor was partially removed. Histopathological examination revealed the tumor cell which had dark nucleus with conspicuous nucleolus and cytoplasmic granules. These findings were compatible with malignant melanoma. Her general condition were deteriorated progressively and she died about 5 months after her admission. Postmortum examination showed diffuse leptomeningeal invasion of dark tumor throughout the entire central nervous system, and metastasis to peritoneum and omentum via V-P shunt system. Histopathological examination proved the tumor to be malignant melanoma. Electrone microscopic examination also revealed melanosome in the cytoplasm. Primary intracranial malignant melanoma is divided in two groups, nodular type and leptomeningeal type. In the latter type, early diagnosis is very difficult, just as in our case, because only a little tissue specimen can be obtained. In a case of leptomenigeal carcinomatosis, possibility of primary malignant melanoma, though rare, should always be kept in mind, and specific staining such as Fontana-Masson's staining should be tried.