Abstract
We describe an elderly male patient who presented with fever of unknown origin and refractory hyponatraemia. Following (18) fluorine-fluorodeoxyglucose positron emission tomography/computed tomography scan and core adrenal biopsy, the diagnosis of diffuse large B-cell non-Hodgkin lymphoma with pituitary and bilateral adrenal involvement was confirmed. After chemotherapy, his symptoms resolved, and all the lesions shrank significantly.
© 2012 The Authors. Internal Medicine Journal © 2012 Royal Australasian College of Physicians.
MeSH terms
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Adrenal Glands / diagnostic imaging
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Adrenal Glands / pathology*
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Aged
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Antineoplastic Combined Chemotherapy Protocols / administration & dosage
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Cyclophosphamide / administration & dosage
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Cyclophosphamide / adverse effects
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Dexamethasone / administration & dosage
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Dexamethasone / adverse effects
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Doxorubicin / administration & dosage
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Doxorubicin / adverse effects
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Fatal Outcome
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Fever of Unknown Origin / etiology
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Humans
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Hyponatremia / etiology
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Hyponatremia / physiopathology
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Lymphoma, Large B-Cell, Diffuse / complications
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Lymphoma, Large B-Cell, Diffuse / diagnostic imaging
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Lymphoma, Large B-Cell, Diffuse / drug therapy
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Lymphoma, Large B-Cell, Diffuse / pathology*
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Male
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Methotrexate / administration & dosage
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Methotrexate / adverse effects
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Multimodal Imaging
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Pituitary Gland / diagnostic imaging
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Pituitary Gland / pathology*
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Pituitary-Adrenal System / physiopathology
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Positron-Emission Tomography
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Prednisone / administration & dosage
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Prednisone / adverse effects
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Tomography, X-Ray Computed
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Ultrasonography
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Vincristine / administration & dosage
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Vincristine / adverse effects
Substances
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Vincristine
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Dexamethasone
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Doxorubicin
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Cyclophosphamide
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Prednisone
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Methotrexate