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Intravascular large B-cell lymphoma causing hypopituitarism and respiratory failure due to infiltration into pulmonary capillaries
  1. Tatsuaki Kosaka1,
  2. Yuki Honda1,
  3. Yoichiro Homma1 and
  4. Masanobu Nakata2
  1. 1General Internal Medicine, Seirei Hamamatsu Hospital, Hamamatsu, Shizuoka, Japan
  2. 2Hematology, Seirei Hamamatsu Hospital, Hamamatsu, Shizuoka, Japan
  1. Correspondence to Dr Tatsuaki Kosaka; tatsuaki_kosaka{at}outlook.jp

Abstract

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.

  • Pituitary disorders
  • Haematology (incl blood transfusion)

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Footnotes

  • Contributors TK managed the case and redaction and correction of the manuscript. YH, MN and YH assisted with redaction, correction and reconstruction of the manuscript. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.