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Diffuse large B cell lymphoma with bilateral adrenal and hypothalamic involvement: A case report and literature review

BACKGROUND: Non-Hodgkin’s lymphoma (NHL) can involve extralymphatic organs, resulting in diverse clinical manifestations, especially if the endocrine organs are affected. This type of involvement can often be difficult to detect accurately. Until now, no patients with NHL and concomitant bilateral a...

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Autores principales: An, Ping, Chen, Kang, Yang, Guo-Qing, Dou, Jing-Tao, Chen, Yu-Long, Jin, Xin-Ye, Wang, Xian-Ling, Mu, Yi-Ming, Wang, Quan-Shun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906562/
https://www.ncbi.nlm.nih.gov/pubmed/31832411
http://dx.doi.org/10.12998/wjcc.v7.i23.4075
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author An, Ping
Chen, Kang
Yang, Guo-Qing
Dou, Jing-Tao
Chen, Yu-Long
Jin, Xin-Ye
Wang, Xian-Ling
Mu, Yi-Ming
Wang, Quan-Shun
author_facet An, Ping
Chen, Kang
Yang, Guo-Qing
Dou, Jing-Tao
Chen, Yu-Long
Jin, Xin-Ye
Wang, Xian-Ling
Mu, Yi-Ming
Wang, Quan-Shun
author_sort An, Ping
collection PubMed
description BACKGROUND: Non-Hodgkin’s lymphoma (NHL) can involve extralymphatic organs, resulting in diverse clinical manifestations, especially if the endocrine organs are affected. This type of involvement can often be difficult to detect accurately. Until now, no patients with NHL and concomitant bilateral adrenal and hypothalamic involvement have been reported. The purpose of this article is to discuss the diagnosis and treatment of lymphoma with bilateral adrenal gland and hypothalamic involvement so as to help physicians avoid misdiagnosis and missed diagnosis. CASE SUMMARY: We describe a case of a 52-years-old male patient with bilateral adrenal masses, who presented with a fever of unknown origin on admission. Subsequently, hypopituitarism of the anterior pituitary followed by posterior pituitary developed. (18)fluorine-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) showed lesions with a high metabolism in both adrenal glands, hypothalamus, left supraclavicular lymph nodes, and other organs. The etiological diagnosis was determined based on a left supraclavicular lymph node biopsy. The patient, who eventually present with panhypopituitarism, was finally diagnosed with diffuse large B cell lymphoma with bilateral adrenal gland and hypothalamic involvement. After immunochemotherapy, glucocorticoids administration and desmopressin acetate replacement therapy, the symptoms of fever and panhypopituitarism improved, and all the lesions reduced in size. CONCLUSION: This report demonstrates that, although synchronous involvement of two endocrine organs is rare in NHL, extra caution should be taken when dysfunction occurs in multiple endocrine organs.
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spelling pubmed-69065622019-12-12 Diffuse large B cell lymphoma with bilateral adrenal and hypothalamic involvement: A case report and literature review An, Ping Chen, Kang Yang, Guo-Qing Dou, Jing-Tao Chen, Yu-Long Jin, Xin-Ye Wang, Xian-Ling Mu, Yi-Ming Wang, Quan-Shun World J Clin Cases Case Report BACKGROUND: Non-Hodgkin’s lymphoma (NHL) can involve extralymphatic organs, resulting in diverse clinical manifestations, especially if the endocrine organs are affected. This type of involvement can often be difficult to detect accurately. Until now, no patients with NHL and concomitant bilateral adrenal and hypothalamic involvement have been reported. The purpose of this article is to discuss the diagnosis and treatment of lymphoma with bilateral adrenal gland and hypothalamic involvement so as to help physicians avoid misdiagnosis and missed diagnosis. CASE SUMMARY: We describe a case of a 52-years-old male patient with bilateral adrenal masses, who presented with a fever of unknown origin on admission. Subsequently, hypopituitarism of the anterior pituitary followed by posterior pituitary developed. (18)fluorine-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) showed lesions with a high metabolism in both adrenal glands, hypothalamus, left supraclavicular lymph nodes, and other organs. The etiological diagnosis was determined based on a left supraclavicular lymph node biopsy. The patient, who eventually present with panhypopituitarism, was finally diagnosed with diffuse large B cell lymphoma with bilateral adrenal gland and hypothalamic involvement. After immunochemotherapy, glucocorticoids administration and desmopressin acetate replacement therapy, the symptoms of fever and panhypopituitarism improved, and all the lesions reduced in size. CONCLUSION: This report demonstrates that, although synchronous involvement of two endocrine organs is rare in NHL, extra caution should be taken when dysfunction occurs in multiple endocrine organs. Baishideng Publishing Group Inc 2019-12-06 2019-12-06 /pmc/articles/PMC6906562/ /pubmed/31832411 http://dx.doi.org/10.12998/wjcc.v7.i23.4075 Text en ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Case Report
An, Ping
Chen, Kang
Yang, Guo-Qing
Dou, Jing-Tao
Chen, Yu-Long
Jin, Xin-Ye
Wang, Xian-Ling
Mu, Yi-Ming
Wang, Quan-Shun
Diffuse large B cell lymphoma with bilateral adrenal and hypothalamic involvement: A case report and literature review
title Diffuse large B cell lymphoma with bilateral adrenal and hypothalamic involvement: A case report and literature review
title_full Diffuse large B cell lymphoma with bilateral adrenal and hypothalamic involvement: A case report and literature review
title_fullStr Diffuse large B cell lymphoma with bilateral adrenal and hypothalamic involvement: A case report and literature review
title_full_unstemmed Diffuse large B cell lymphoma with bilateral adrenal and hypothalamic involvement: A case report and literature review
title_short Diffuse large B cell lymphoma with bilateral adrenal and hypothalamic involvement: A case report and literature review
title_sort diffuse large b cell lymphoma with bilateral adrenal and hypothalamic involvement: a case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906562/
https://www.ncbi.nlm.nih.gov/pubmed/31832411
http://dx.doi.org/10.12998/wjcc.v7.i23.4075
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