title: A rare case of anasarca caused by infiltration of the pituitary gland by diffuse large B-cell lymphoma.
abstract: BACKGROUND
  Anasarca in patients with lymphoma is a rare symptom. We report a patient with DLBCL associated with pituitary gland infiltration that was diagnosed based on significant anasarca.
  
  
  METHODS
  A 72-year-old woman with a 10-year history of hypertension visited a local hospital presenting with anasarca and 15-kg weight gain in the past 3 months. we clinically diagnosed central hypothyroidism caused by pituitary gland infiltration of diffuse large B-cell lymphoma (DLBCL) (clinical stage IV in the Ann Arbor staging classification). The first course of chemotherapy improved anasarca remarkably and the patient's body weight returned to what it was 3 months before.
  
  
  CONCLUSIONS
  We experienced a patient with remarkable anasarca caused by DLBCL infiltration of the pituitary gland. A pituitary gland lesion with central hypothyroidism should be considered as one of the differential diagnoses of edema. This case was very valuable because we could assess it by following the time course of symptoms (edema and delayed relaxation time of the Achilles tendon reflex), laboratory data, and imaging findings (swelling anterior pituitary lobe).
authors.affiliation: Division of General Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. ayako-kumabe@jichi.ac.jp.
authors.forename: Ayako
authors.initials: A
authors.lastname: Kumabe
authors.affiliation: Division of General Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. smile.kenzaka@jichi.ac.jp.
authors.forename: Tsuneaki
authors.initials: T
authors.lastname: Kenzaka
authors.affiliation: Division of General Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. yoshioki@jichi.ac.jp.
authors.forename: Yoshioki
authors.initials: Y
authors.lastname: Nishimura
authors.affiliation: Department of Internal Medicine, Division of Hematology, Jichi Medical University, Shimotsuke, Japan. masakinitami@gmail.com.
authors.forename: Masaki
authors.initials: M
authors.lastname: Aikawa
authors.affiliation: Department of Internal Medicine, Division of Hematology, Jichi Medical University, Shimotsuke, Japan. mmasaki@jichi.ac.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.affiliation: Division of General Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. nephron@jichi.ac.jp.
authors.forename: Masami
authors.initials: M
authors.lastname: Matsumura
mesh_terms: D000368:Aged; D004487:Edema / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000209:etiology; D017254:Leukemic Infiltration / Q000150:complications*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000473:pathology*; D010903:Pituitary Gland, Anterior / Q000473:pathology*