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The Clinical and Hormonal Characteristics of Primary Adrenal Lymphomas: The Necessity of Early Detection of Adrenal Insufficiency
- Source :
- Internal Medicine
- Publication Year :
- 2017
- Publisher :
- Japanese Society of Internal Medicine, 2017.
-
Abstract
- Objective To analyze the clinical and endocrine characteristics of patients with primary adrenal lymphoma. Patients We retrospectively reviewed the cases of five patients with primary adrenal lymphoma who were treated in our hospital between April 2004 and March 2015. We investigated the characteristics of the clinical and pathological findings, treatment, prognosis and complications of adrenal insufficiency. Results Adrenal insufficiency, which was confirmed by the laboratory data at the initial presentation, was observed in two cases. One case was complicated by relative adrenal insufficiency during a course of chemotherapy. The plasma adrenaline and urinary adrenaline levels were decreased in four cases and three cases, respectively. Diffusion MRI was radiologically diagnostic. In all of the cases, the patients were pathologically diagnosed with diffuse large-B cell lymphoma and were treated with rituximab and CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone)-like chemotherapy. Two patients received central nervous system prophylaxis with high-dose methotrexate. Four of the patients survived and one patient died during the follow-up period. Conclusion The early detection of adrenal insufficiency and the administration of an appropriate dose of hydrocortisone are necessary during the course of chemotherapy as well as at the initial manifestation. The exclusion of adrenal dysfunction prior to invasive diagnostic procedures, such as CT-guided needle biopsy, is also critical.
- Subjects :
- adrenal tumor
Adult
Male
medicine.medical_specialty
Vincristine
diffuse large B-cell lymphoma
030209 endocrinology & metabolism
CHOP
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Prednisone
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
Internal Medicine
Adrenal insufficiency
medicine
Humans
Cyclophosphamide
Adrenocortical Insufficiency
Early Detection of Cancer
adrenocortical insufficiency
Aged
Retrospective Studies
Hydrocortisone
Aged, 80 and over
business.industry
primary adrenal lymphoma
General Medicine
Middle Aged
Prognosis
medicine.disease
Methotrexate
Treatment Outcome
Doxorubicin
030220 oncology & carcinogenesis
Immunology
Original Article
Female
Rituximab
Lymphoma, Large B-Cell, Diffuse
business
Diffuse large B-cell lymphoma
Adrenal Insufficiency
medicine.drug
Subjects
Details
- ISSN :
- 13497235 and 09182918
- Volume :
- 56
- Database :
- OpenAIRE
- Journal :
- Internal Medicine
- Accession number :
- edsair.doi.dedup.....3401fc400f0ec6fa47b0ff8942d7df92
- Full Text :
- https://doi.org/10.2169/internalmedicine.8216-16