The 497th case: fever, anterior hypopituitarism, lymphadenopathy

VernacularTitle:第497例——发热，垂体前叶功能减退，淋巴结肿大
Author: Xiaoming WEN ¹ ; Jing SUN ; Xinxin LIANG ; Lingling XU ; Xiaoyun ZENG
Author Information

1. 南方医科大学深圳医院内分泌科，深圳　518101
Keywords: Lymphoma, T-cell; Pituitary gland; Fever; Hypopituitarism
From: Chinese Journal of Internal Medicine 2022;61(7):836-839
CountryChina
Language:Chinese
Abstract: A 57-year-old woman was admitted to hospital with fever. She still had fever treated with multiple antibiotics, and no definite evidence for infection was found. Hypothermia and hypotension developed, and magnetic resonance imaging (MRI) examination showed enlarged anterior pituitary and multiple small nodular lesions with mild enhancement on the left side. Hormone replacement and anti-infection treatment were administrated, but fever did not improve. Remarkable lymphadenopathy was found in left supraclavicular area. The pathology of lymph node biopsy indicated peripheral T-cell lymphoma (not otherwise specified, NOS). Positron emission tomography-computed tomography (PET-CT) revealed hypermetabolism in multiple lymph nodes, infiltration of the liver and spleen. The final diagnosis were peripheral T-cell lymphoma with involvement of liver and spleen (stage Ⅳ) and anterior hypopituitarism. After chemotherapy, fever alleviated and the function of anterior pituitary recovered gradually.