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Pituitary and adrenal involvement in diffuse large B-cell lymphoma, with recovery of their function after chemotherapy
BACKGROUND: Diffuse large B-cell lymphoma sometimes involves the endocrine organs, but involvement of both the pituitary and adrenal glands is extremely rare. Involvement of these structures can lead to hypopituitarism and adrenal insufficiency, and subsequent recovery of their function is rarely se...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3851926/ https://www.ncbi.nlm.nih.gov/pubmed/24106823 http://dx.doi.org/10.1186/1472-6823-13-45 |
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author | Nakashima, Yasuhiro Shiratsuchi, Motoaki Abe, Ichiro Matsuda, Yayoi Miyata, Noriyuki Ohno, Hirofumi Ikeda, Motohiko Matsushima, Takamitsu Nomura, Masatoshi Takayanagi, Ryoichi |
author_facet | Nakashima, Yasuhiro Shiratsuchi, Motoaki Abe, Ichiro Matsuda, Yayoi Miyata, Noriyuki Ohno, Hirofumi Ikeda, Motohiko Matsushima, Takamitsu Nomura, Masatoshi Takayanagi, Ryoichi |
author_sort | Nakashima, Yasuhiro |
collection | PubMed |
description | BACKGROUND: Diffuse large B-cell lymphoma sometimes involves the endocrine organs, but involvement of both the pituitary and adrenal glands is extremely rare. Involvement of these structures can lead to hypopituitarism and adrenal insufficiency, and subsequent recovery of their function is rarely seen. The present report describes an extremely rare case of pituitary and adrenal diffuse large B-cell lymphoma presenting with hypopituitarism and adrenal insufficiency with subsequent recovery of pituitary and adrenal function after successful treatment of the lymphoma. CASE PRESENTATION: A 63-year-old Japanese man was referred to our hospital due to miosis, ptosis, hypohidrosis of his left face, polydipsia and polyuria. (18)F-fluorodeoxy glucose positron emission tomography / computed tomography revealed hotspots in the pituitary gland, bilateral adrenal glands and the apex of his left lung. Surgical biopsy from the pituitary lesion confirmed the diagnosis of diffuse large B-cell lymphoma, with lymphoma cells replacing normal pituitary tissue. Endocrine function tests revealed adrenal insufficiency and panhypopituitarism, including a possible affection of the posterior pituitary. Hormone replacement therapy with desmopressin and hydrocortisone was started. Chemotherapy consisted of six courses of R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin and prednisolone) and two courses of high-dose methotrexate followed by autologous hematopoietic stem cell transplantation. Subsequently, his pituitary and bilateral adrenal lesions resolved, and serial endocrine function tests showed gradual improvement in pituitary and adrenal function. CONCLUSIONS: The present report describes an extremely rare case of diffuse large B-cell lymphoma with involvement of both the pituitary and bilateral adrenal glands. R-CHOP and high-dose methotrexate therapy followed by autologous hematopoietic stem cell transplantation was quite effective, and panhypopituitarism and adrenal insufficiency improved to almost normal values after successful treatment of the lymphoma with chemotherapy. |
format | Online Article Text |
id | pubmed-3851926 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-38519262013-12-06 Pituitary and adrenal involvement in diffuse large B-cell lymphoma, with recovery of their function after chemotherapy Nakashima, Yasuhiro Shiratsuchi, Motoaki Abe, Ichiro Matsuda, Yayoi Miyata, Noriyuki Ohno, Hirofumi Ikeda, Motohiko Matsushima, Takamitsu Nomura, Masatoshi Takayanagi, Ryoichi BMC Endocr Disord Case Report BACKGROUND: Diffuse large B-cell lymphoma sometimes involves the endocrine organs, but involvement of both the pituitary and adrenal glands is extremely rare. Involvement of these structures can lead to hypopituitarism and adrenal insufficiency, and subsequent recovery of their function is rarely seen. The present report describes an extremely rare case of pituitary and adrenal diffuse large B-cell lymphoma presenting with hypopituitarism and adrenal insufficiency with subsequent recovery of pituitary and adrenal function after successful treatment of the lymphoma. CASE PRESENTATION: A 63-year-old Japanese man was referred to our hospital due to miosis, ptosis, hypohidrosis of his left face, polydipsia and polyuria. (18)F-fluorodeoxy glucose positron emission tomography / computed tomography revealed hotspots in the pituitary gland, bilateral adrenal glands and the apex of his left lung. Surgical biopsy from the pituitary lesion confirmed the diagnosis of diffuse large B-cell lymphoma, with lymphoma cells replacing normal pituitary tissue. Endocrine function tests revealed adrenal insufficiency and panhypopituitarism, including a possible affection of the posterior pituitary. Hormone replacement therapy with desmopressin and hydrocortisone was started. Chemotherapy consisted of six courses of R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin and prednisolone) and two courses of high-dose methotrexate followed by autologous hematopoietic stem cell transplantation. Subsequently, his pituitary and bilateral adrenal lesions resolved, and serial endocrine function tests showed gradual improvement in pituitary and adrenal function. CONCLUSIONS: The present report describes an extremely rare case of diffuse large B-cell lymphoma with involvement of both the pituitary and bilateral adrenal glands. R-CHOP and high-dose methotrexate therapy followed by autologous hematopoietic stem cell transplantation was quite effective, and panhypopituitarism and adrenal insufficiency improved to almost normal values after successful treatment of the lymphoma with chemotherapy. BioMed Central 2013-10-09 /pmc/articles/PMC3851926/ /pubmed/24106823 http://dx.doi.org/10.1186/1472-6823-13-45 Text en Copyright © 2013 Nakashima et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Nakashima, Yasuhiro Shiratsuchi, Motoaki Abe, Ichiro Matsuda, Yayoi Miyata, Noriyuki Ohno, Hirofumi Ikeda, Motohiko Matsushima, Takamitsu Nomura, Masatoshi Takayanagi, Ryoichi Pituitary and adrenal involvement in diffuse large B-cell lymphoma, with recovery of their function after chemotherapy |
title | Pituitary and adrenal involvement in diffuse large B-cell lymphoma, with recovery of their function after chemotherapy |
title_full | Pituitary and adrenal involvement in diffuse large B-cell lymphoma, with recovery of their function after chemotherapy |
title_fullStr | Pituitary and adrenal involvement in diffuse large B-cell lymphoma, with recovery of their function after chemotherapy |
title_full_unstemmed | Pituitary and adrenal involvement in diffuse large B-cell lymphoma, with recovery of their function after chemotherapy |
title_short | Pituitary and adrenal involvement in diffuse large B-cell lymphoma, with recovery of their function after chemotherapy |
title_sort | pituitary and adrenal involvement in diffuse large b-cell lymphoma, with recovery of their function after chemotherapy |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3851926/ https://www.ncbi.nlm.nih.gov/pubmed/24106823 http://dx.doi.org/10.1186/1472-6823-13-45 |
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