Diffuse large B cell lymphoma with bilateral adrenal and hypothalamic involvement: A case report and literature review

Table 4 Time line

Data
2017-08-03	Admitted with bilateral adrenal occupying lesions and fever
2017-08-04	Laboratory examinations: Impaired liver function, decreased platelet count, and elevated LDH and β2-MG
2017-08-07	Decreased cortisol and ACTH
2017-08-09	Decreased TSH, FT3, FT4, LH, FSH, and testosterone
2017-08-10	MRI: A hypothalamic space occupying lesion; physical examination: rash and enlarged left supraclavicular lymph nodes; diagnosed with anterior pituitary hypofunction; treated with hydrocortisone
2017-08-11	Fever disappeared
2017-08-14	Low specific gravity urine and hypernatremia; diagnosed with panhypopituitrism; treated with desmopressin acetate and prednisone acetate
2017-08-15	Symptoms of polyuria and thirst were relieved; Biopsy: DLBCL
2017-08-17	PET/CT: high metabolism in bilateral adrenal glands, the sellar area, left supraclavicular lymph nodes, retroperitoneal lymph nodes, left tonsil, and left testis
2017-08-22	Started R-CHOP immunochemotherapy
2017-12-15	PET/CT: All lesions disappeared
2018-05-17	Treated with autologous stem cell transplantation

LDH; Lactate dehydrogenase; ACTH: Adrenocorticotrophic hormone; DLBCL: Diffuse large B cell lymphoma; PET/CT: Positron emission tomography/computed tomography.