Functional adrenocortical adenoma in a case with B cell chronic lymphoproliferative disorder.
We describe a B cell chronic lymphocytic leukemia/lymphoma (B-CLL) patient with an adrenocortical adenoma. He was treated initially with oral cyclophosphamide and prednisolone for 2 months, followed by low-dose prednisolone for an additional 2 years, which resulted in the prompt disappearance of CLL cells. After a period of 2 years without therapy, a functional adrenocortical adenoma was found. After adrenalectomy, the CLL cells rapidly increased. Progression of the disease and clinical-hematological relapse was well controlled by low doses of steroids alone, and the patient's condition stabilized. Considering the recent data that corticosteroids can induce apoptosis of CLL cells, the above clinical course suggests that augmented glucocorticoid production from the tumor may have suppressed disease progression.
Adachi
Y
Y
First Department of Internal Medicine, Sapporo Medical University School of Medicine, Japan.
Adachi
M
M
Hinoda
Y
Y
Fukushima
H
H
Takahashi
T
T
Imai
K
K
D000236:Adenoma / Q000150:complications / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D000315:Adrenalectomy / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003480:Cushing Syndrome / Q000209:etiology; D003520:Cyclophosphamide / Q000008:administration & dosage; D018450:Disease Progression; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D009378:Neoplasms, Multiple Primary; D011239:Prednisolone / Q000008:administration & dosage
D000305:Adrenal Cortex Hormones; D003520:Cyclophosphamide; D011239:Prednisolone; D006854:Hydrocortisone