General Internal Medicine, Seirei Hamamatsu Hospital, Hamamatsu, Shizuoka, Japan
General Internal Medicine, Seirei Hamamatsu Hospital, Hamamatsu, Shizuoka, Japan.
BMJ Case Rep. 2022 May 24;15(5):e247880. doi: 10.1136/bcr-2021-247880.
We report a rare case of intravascular large B-cell lymphoma (IVLBCL) with hypopituitarism and respiratory failure. A man in his 80s presented with hypotension and respiratory failure but was unsuccessfully treated for septic shock. Biological investigations were performed, and he was diagnosed with hypopituitarism due to insufficient secretion of anterior pituitary hormone. Although his condition temporarily improved following hormone replacement therapy, he eventually died of progressive respiratory failure. The lymphoma was only discovered during the autopsy, where it was observed to have spread to the pituitary gland and lung capillaries. Therefore, we concluded that the lymphoma had caused respiratory failure and hypopituitarism. The patient was thus diagnosed with IVLBCL posthumously. In conclusion, IVLBCL can cause hypopituitarism and respiratory failure due to pituitary and pulmonary capillary invasion by lymphoma cells.
我们报告一例罕见的伴有垂体功能减退和呼吸衰竭的血管内大 B 细胞淋巴瘤(IVLBCL)病例。一位 80 多岁的男性因低血压和呼吸衰竭就诊,但因感染性休克治疗无效。进行了生物学研究,他被诊断为由于前垂体激素分泌不足导致的垂体功能减退。尽管在激素替代治疗后他的病情暂时有所改善,但最终死于进行性呼吸衰竭。尸检时才发现淋巴瘤,观察到它已扩散到垂体和肺毛细血管。因此,我们认为淋巴瘤导致了呼吸衰竭和垂体功能减退。该患者因此被死后诊断为 IVLBCL。总之,IVLBCL 可因淋巴瘤细胞侵犯垂体和肺毛细血管而导致垂体功能减退和呼吸衰竭。