Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2021) 75 A07 | DOI: 10.1530/endoabs.75.A07

1Unit of Endocrinology and Diabetes, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Università Cattolica del Sacro Cuore; [email protected]; 2Unit of Endocrinology and Diabetes, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy

Background: Diffuse large B-cell lymphoma is the most common non-Hodgkin’s lymphoma (NHL). It can involve extranodal sites in about 30%, but the involvement of endocrine organs is rare (adrenal involvement is estimated<0.2%) and correlates with poor prognosis. In contrast to pituitary metastases from solid tumors, NHL involvement of the anterior lobe of the pituitary is more frequently seen.

Case presentation: A 84-year-old woman presented to the A&E for intermittent fever, progressive fatigue, night sweats and weight loss started from two months. She referred increasing pain in the left upper quadrant of abdomen. Computed tomography revealed a 8×7 cm left adrenal gland mass with diffuse abdominal lymphadenomegaly. Labs revealed central hypoadrenalism (ACTH 20 pg/ml, serum cortisol 30 ng/ml) with hyponatremia (128 mmol/l) and normokalemia (4.2 mmol/l). Additional evaluations revealed anterior hypopituitarism: TSH:0.01μUI/ml, FT3:1.3 pg/ml, FT4:4.8 pg/ml, FSH:2.5 mU/ml, LH:0.2 mU/ml, IGF-I:<15.00 ng/ml, PRL:55.7 ng/ml. The patient was treated with hydrocortisone 30 mg/day and thyroxine 75 mg/day. Pituitary magnetic resonance showed a 1.3×2.2×1.2 cm heterogeneous mass with intrasellar and suprasellar extension and thickening of the pituitary peduncle. FDG-18 PET/CT revealed lesions with a high metabolism in left adrenal gland, pituitary, nodes, liver and other organs. Following left adrenal biopsy, the diagnosis of diffuse large B-cell non-Hodgkin lymphoma with pituitary and adrenal involvement was confirmed. Ki-67 index was 65%. The patient later died during hospitalisation after developing massive pulmonary thromboembolism and respiratory failure.

Conclusions: In presence of NHL, endocrine involvement and endocrine dysfunctions must be considered. Clinical signs and symptoms may overlap. A biochemical endocrine assessment should be evaluated, so that a rapid and effective therapy can be started. Hormonal dysfunctions may also be reversible after treatment of lymphoma.

Volume 75

ESE Young Endocrinologists and Scientists (EYES) Annual Meeting

European Society of Endocrinology 

Browse other volumes

Article tools

My recent searches

No recent searches.