A sarcoidosis-lymphoma syndrome revealed by hypopituitarism
| العنوان: | A sarcoidosis-lymphoma syndrome revealed by hypopituitarism |
|---|---|
| المؤلفون: | Véronique Roelants, Halil Yildiz, Alessandra Camboni, Eric Van Den Neste, Raluca Maria Furnica, Dominique Maiter, Jean-Paul Thissen, Alexandra Kozyreff, Charlotte Delcourt |
| المساهمون: | UCL - SSS/DDUV - Institut de Duve, UCL - SSS/DDUV/BCHM - Biochimie-Recherche métabolique, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - SSS/IREC/GYNE - Pôle de Gynécologie, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service d'endocrinologie et de nutrition, UCL - (SLuc) Service de médecine interne générale, UCL - (SLuc) Service d'anatomie pathologique, UCL - (SLuc) Service de médecine nucléaire, UCL - (SLuc) Service d'ophtalmologie |
| المصدر: | Endocrinology, diabetes & metabolism case reports, Vol. 2019, no.1, p. 19-0091 [1-6] (2019) Endocrinology, Diabetes & Metabolism Case Reports Endocrinology, Diabetes & Metabolism Case Reports, Vol 1, Iss 1, Pp 1-6 (2019) |
| بيانات النشر: | Bioscientifica, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Anterior hypopituitarism, LH, Systemic disease, Hypercalcaemia, Hydrocortisone, Endocrinology, Diabetes and Metabolism, General Practice, Levothyroxine, Lymphadenopathy, White, Hypopituitarism, lcsh:Diseases of the endocrine glands. Clinical endocrinology, Haematoxylin and eosin staining, Cortisol, 0302 clinical medicine, Nodular sclerosis, Belgium, FSH, FT4, Fatigue, September, medicine.diagnostic_test, TSH, New disease or syndrome: presentations/diagnosis/management, IGF1, Headache, Immunohistochemistry, Dacarbazine, 030220 oncology & carcinogenesis, Female, Sarcoidosis, Radiology, General practice, MRI, PTH, CT scan, medicine.medical_specialty, Mediastinal lymphadenopathy, Thyroxine (T4), Histopathology, 030209 endocrinology & metabolism, Methylprednisolone, C-reactive protein, Adolescent/young adult, X-ray, 03 medical and health sciences, Lymphadenitis, Biopsy, Internal Medicine, medicine, Chemotherapy, Glucocorticoids, lcsh:RC648-665, business.industry, PET scan, medicine.disease, Lymphoma, ACTH, 25-hydroxyvitamin-D3, Pituitary, business, Cortisol (9am) |
| الوصف: | A 26-year-old woman presented with persistent headache and tiredness. Biological investigations disclosed a moderate inflammatory syndrome, low PTH-hypercalcemia and complete anterior hypopituitarism. A magnetic resonance imaging (MRI) of the pituitary gland was performed and revealed a symmetric enlargement with a heterogeneous signal. Ophthalmological examination showed an asymptomatic bilateral anterior and posterior uveitis, and a diagnosis of pituitary sarcoidosis was suspected. As the localization of lymphadenopathies on the fused whole-body FDG-PET/computerized tomography (CT) was not evoking a sarcoidosis in first instance, an excisional biopsy of a left supraclavicular adenopathy was performed showing classic nodular sclerosis Hodgkin’s lymphoma (HL). A diagnostic transsphenoidal biopsy of the pituitary gland was proposed for accurate staging of the HL and surprisingly revealed typical granulomatous inflammation secondary to sarcoidosis, leading to the diagnosis of a sarcoidosis–lymphoma syndrome. The co-existence of these diseases constitutes a diagnostic challenge and we emphasize the necessity of exact staging of disease in order to prescribe adequate treatment. Learning points: The possibility of a sarcoidosis–lymphoma syndrome, although rare, should be kept in mind during evaluation for lymphadenopathies. In the case of such association, lymphoma usually occurs after sarcoidosis. However, sarcoidosis and lymphoma can be detected simultaneously and development of sarcoidosis in a patient with previous lymphoma has also been reported. An accurate diagnosis of the disease and the respective organ involvements, including biopsy, is necessary in order to prescribe adequate treatment. Patient Demographics: Adolescent/young adult, Female, White, Belgium Clinical Overview: Pituitary, Pituitary, PTH, FSH, ACTH, Cortisol, IGF1, LH, Thyroxine (T4), TSH, Hypopituitarism, Hypercalcaemia, Lymphadenopathy Diagnosis and Treatment: Headache, Fatigue, Hypercalcaemia, Hypopituitarism, Lymphadenitis, Sarcoidosis, CT scan, MRI, PET scan, PTH, C-reactive protein, 25-hydroxyvitamin-D3, X-ray, Cortisol (9am), ACTH, FT4, FSH, LH, IGF1, TSH, Histopathology, Haematoxylin and eosin staining, Immunohistochemistry, Chemotherapy, Hydrocortisone, Glucocorticoids, Levothyroxine, Dacarbazine, Methylprednisolone Related Disciplines: General practice Publication Details: New disease or syndrome: presentations/diagnosis/management, September, 2019 Background Sarcoidosis is a systemic disease of unknown etiology characterized by non-caseified granulomatous reaction that can involve multiple organs. It is more frequent in young and middle-aged adults and typically presents with pulmonary infiltrates, bilateral hilar and mediastinal lymphadenopathy, uveitis, and more rarely affects other organs, including the hypothalamic–pituitary axis. Malignancy rates in sarcoidosis patients have been reported as 1.2–2.5% (1, 2), chronic inflammation being a risk factor. The risk of hematologic malignancy is especially higher among these patients, so that the existence of a specific sarcoidosis-lymphoma syndrome has been suggested. Our paper reports one such rare case of co-occurrence of pituitary sarcoidosis and Hodgkin’s lymphoma (HL). |
| اللغة: | English |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::41a531fd2e641ae85310dec32ae359ed https://hdl.handle.net/2078.1/223979 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....41a531fd2e641ae85310dec32ae359ed |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |