The Clinical and Hormonal Characteristics of Primary Adrenal Lymphomas: The Necessity of Early Detection of Adrenal Insufficiency

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 character...

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Autores principales: Harada, Ko, Kimura, Kosuke, Iwamuro, Masaya, Terasaka, Tomohiro, Hanayama, Yoshihisa, Kondo, Eisei, Hayashi, Eiko, Yoshino, Tadashi, Otsuka, Fumio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5635296/
https://www.ncbi.nlm.nih.gov/pubmed/28794358
http://dx.doi.org/10.2169/internalmedicine.8216-16
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author Harada, Ko
Kimura, Kosuke
Iwamuro, Masaya
Terasaka, Tomohiro
Hanayama, Yoshihisa
Kondo, Eisei
Hayashi, Eiko
Yoshino, Tadashi
Otsuka, Fumio
author_facet Harada, Ko
Kimura, Kosuke
Iwamuro, Masaya
Terasaka, Tomohiro
Hanayama, Yoshihisa
Kondo, Eisei
Hayashi, Eiko
Yoshino, Tadashi
Otsuka, Fumio
author_sort Harada, Ko
collection PubMed
description 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.
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spelling pubmed-56352962017-10-12 The Clinical and Hormonal Characteristics of Primary Adrenal Lymphomas: The Necessity of Early Detection of Adrenal Insufficiency Harada, Ko Kimura, Kosuke Iwamuro, Masaya Terasaka, Tomohiro Hanayama, Yoshihisa Kondo, Eisei Hayashi, Eiko Yoshino, Tadashi Otsuka, Fumio Intern Med Original Article 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. The Japanese Society of Internal Medicine 2017-08-10 2017-09-01 /pmc/articles/PMC5635296/ /pubmed/28794358 http://dx.doi.org/10.2169/internalmedicine.8216-16 Text en Copyright © 2017 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Harada, Ko
Kimura, Kosuke
Iwamuro, Masaya
Terasaka, Tomohiro
Hanayama, Yoshihisa
Kondo, Eisei
Hayashi, Eiko
Yoshino, Tadashi
Otsuka, Fumio
The Clinical and Hormonal Characteristics of Primary Adrenal Lymphomas: The Necessity of Early Detection of Adrenal Insufficiency
title The Clinical and Hormonal Characteristics of Primary Adrenal Lymphomas: The Necessity of Early Detection of Adrenal Insufficiency
title_full The Clinical and Hormonal Characteristics of Primary Adrenal Lymphomas: The Necessity of Early Detection of Adrenal Insufficiency
title_fullStr The Clinical and Hormonal Characteristics of Primary Adrenal Lymphomas: The Necessity of Early Detection of Adrenal Insufficiency
title_full_unstemmed The Clinical and Hormonal Characteristics of Primary Adrenal Lymphomas: The Necessity of Early Detection of Adrenal Insufficiency
title_short The Clinical and Hormonal Characteristics of Primary Adrenal Lymphomas: The Necessity of Early Detection of Adrenal Insufficiency
title_sort clinical and hormonal characteristics of primary adrenal lymphomas: the necessity of early detection of adrenal insufficiency
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5635296/
https://www.ncbi.nlm.nih.gov/pubmed/28794358
http://dx.doi.org/10.2169/internalmedicine.8216-16
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