[Bilateral non-Hodgkin's lymphoma of the adrenal glands with adrenal insufficiency].
A 66-year-old female presented with anorexia, fatigue, skin pigmentation, weight loss and low grade fever. Imaging studies demonstrated bilateral bulky masses confined to the adrenal glands. Ultrasonography guided needle biopsy of the mass showed findings of diffuse large B-sell lymphoma. Low levels of serum cortisol, urinary 17-OHCS and 17-KS, a high level of ACTH and a non-reactive pattern on the rapid ACTH test led to a diagnosis of Addison's disease. Only a partial regression was achieved by the first chemotherapy. She died due to disease progression, while the next course of chemotherapy had been postponed because of interstitial pneumonitis due to methotrexate.
First department of Internal Medicine, Sapporo Medical University School of Medicine.
T
T
Takahashi
S
S
Ishii
S
S
Atsumi
H
H
Mita
T
T
Hayashi
M
M
Adachi
Y
Y
Hinoda
N
N
Toyoshima
K
K
Imai
D015065:17-Hydroxycorticosteroids / Q000652:urine; D000224:Addison Disease / Q000175:diagnosis / Q000209:etiology*; D000310:Adrenal Gland Neoplasms / Q000150:complications*; D000324:Adrenocorticotropic Hormone / Q000652:urine; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000139:chemically induced; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications*; D008727:Methotrexate / Q000009:adverse effects
D015065:17-Hydroxycorticosteroids; D000324:Adrenocorticotropic Hormone; D008727:Methotrexate