case_images: PMC6512020_01
case_images: PET-CT hypermetabolic splenomegaly, perihepatic hypermetabolic lymph nodes, and cervical hypermetabolism.
case_images: CRIHEM2019-9625075.001.jpg
case_images: PMC6512020_01_CRIHEM2019-9625075.001.jpg
case_images: fig1
case_images: Clinical examination found a huge splenomegaly, confirmed by abdominal CT scan but no arthritis. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18FDG PET-CT) showed an enlarged hypermetabolic spleen and perisplenic and hilar hepatic hypermetabolic lymph nodes with hypermetabolism around the cervix (Figure 1).
case_images: Hemophagocytosis at bone marrow aspiration.
case_images: CRIHEM2019-9625075.002.jpg
case_images: PMC6512020_01_CRIHEM2019-9625075.002.jpg
case_images: fig2
case_images: New biological investigations were suggestive of HPS (sCD25 at 15000 pg/mL and ferritin at 1740 mug/L) with evidence of hemophagocytosis at bone marrow aspirates, with acute renal failure and hypopituitarism (Figure 2), clearly concerning gonadotropic axis and thyrotropic axis.
case_images: Brain MRI showing enlargement of the pituitary gland and pituitary stalk without evidence of adenoma.
case_images: CRIHEM2019-9625075.003.jpg
case_images: PMC6512020_01_CRIHEM2019-9625075.003.jpg
case_images: fig3
case_images: Brain MRI presented an enlarged pituitary gland and pituitary stalk with nonspecific lesions (Figure 3).
case_images: Brain MRI showing left prerolandic lesion and medial medullary hypersignal. (a) Prerolandic lesion with homogeneous corticosubcortical ring enhancement. (b) Medial medullary hypersignal in T2 and flair.
case_images: CRIHEM2019-9625075.004.jpg
case_images: PMC6512020_01_CRIHEM2019-9625075.004.jpg
case_images: fig4
case_images: It showed a hypersignaling (T2/flair) medial medullary lesion associated with corticosubcortical prerolandic homogeneous lesion (Figure 4).