Takahashi T, Ishii S, Atsumi S, Mita H, Hayashi T, Adachi M, Hinoda Y, Toyoshima N, Imai K
First department of Internal Medicine, Sapporo Medical University School of Medicine.
Rinsho Ketsueki. 1996 Sep;37(9):867-9.
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.
一名66岁女性出现厌食、乏力、皮肤色素沉着、体重减轻和低热症状。影像学检查显示双侧肾上腺有巨大肿块。超声引导下对肿块进行穿刺活检，结果显示为弥漫性大B细胞淋巴瘤。血清皮质醇、尿17-羟皮质类固醇（17-OHCS）和17-酮类固醇（17-KS）水平低，促肾上腺皮质激素（ACTH）水平高，且快速ACTH试验呈无反应模式，从而诊断为艾迪生病。首次化疗仅实现了部分缓解。她因疾病进展而死亡，而下一疗程的化疗因甲氨蝶呤导致的间质性肺炎而推迟。
