Functioning adrenal black adenoma with pulmonary and cutaneous cryptococcosis: A case report and review of English literature

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• 作者：S. Takahashi ; H. Iijima ; Dr. Yuji Moriwaki…
• 关键词：Cushing鈥檚 syndrome ; black adenoma ; cryptococcosis ; opportunistic infection ; diabetes mellitus
• 刊名：Journal of Endocrinological Investigation
• 出版年：2001
• 出版时间：November 2001
• 年：2001
• 卷：24
• 期：10
• 页码：816-819
• 全文大小：
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  14.Kramer M., Corrado M.L., Bacci V., Carter A.C., Landesman S.H. Pulmonary cryptococcosis and Cushing鈥檚 syndrome. Arch. Intern. Med. 1983, 143: 2179鈥?180.PubMed CrossRef
  15.Drew P.A, Takezawa K. Pulmonary cryptococcosis and pituitary Cushing鈥檚 disease. Diag. Cytopathol. 1998, 18: 365鈥?67.CrossRef
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• 作者单位：S. Takahashi (113)
  H. Iijima (113)
  Dr. Yuji Moriwaki (113)
  T. Yamamoto (113)
  S. Matsuoka (113)
  Z. Tsutsumi (113)
  M. Nojima (213)
  A. Kubota (313)
  T. Hada (113)
  
  113. Third Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo, 663-8501, Japan
  213. Department of Urology, Hyogo College of Medicine, Japan
  313. Department of Surgical Pathology, Hyogo College of Medicine, Hyogo, Japan
  
• 刊物类别：Medicine/Public Health, general; Endocrinology; Metabolic Diseases;
• 刊物主题：Medicine/Public Health, general; Endocrinology; Metabolic Diseases;
• 出版者：Springer International Publishing
• ISSN：1720-8386

文摘

A 53-year-old woman experienced progressive general weakness and lumbago in the 2 years prior to a physical examination which disclosed cushingoid manifestations and a skin ulcer on the back of her right knee joint. Her plasma cortisol concentration ranged from 24.7 to 31.1 渭g/dl, with an ACTH level <5 pg/ml. Urinary excretions of 17-hydroxycorticosteroid (17-OHCS) and 17-ketosteroid (17-KS) were 20.5 mg/day and 5.1 mg/day, respectively, and urinary cortisol was also increased (421 渭g/day). Cortisol was not suppressed after the administration of 8 mg dexamethasone. Abdominal ultrasound sonography, computed tomography (CT) scan, and magnetic resonance imaging (MRI) studies demonstrated a left adrenal tumor and further, a chest X-ray examination showed a cavitary lesion containing a fungus ball-like mass in the left lower lung field. The serum cryptococcal antigen titer was positive at 1:128 and a bronchoalveolar lavage fluid culture yielded a growth of Cryptococcus neoformans. A biopsy specimen of the skin ulcer also suggested cryptococcosis. As a result, a left adrenectomy was performed, and the excised specimen was shown to be an adenoma consisting of compact cells with abundant pigmentation (black adenoma). A diagnosis of functioning black adenoma of the adrenal gland, complicated with pulmonary and cutaneous cryptococcosis was made. Key-words Cushing鈥檚 syndrome black adenoma cryptococcosis opportunistic infection diabetes mellitus