[Malignant lymphoma associated with Addison's disease]

A 62-year-old man was admitted to our hospital in Oct. 1986, because of easy fatigability, generalized pigmentation and lymph node swelling. Radiological examination showed massive adrenal tumor and two lung tumors. Endocrinological findings showed cortisol 8.3 micrograms/dl, aldosterone 35.3 ng/dl, ACTH 348 pg/ml, and non reacting pattern was observed in ACTH-overloading test, suggesting a presence of Addison's disease. A diagnosis of malignant lymphoma (Non-Hodgkin's lymphoma, diffuse large cell type) was made by lymph node biopsy, and radiotherapy to bulky bilateral adrenal tumors and cervical lymph nodes was performed with some response. Then, treatment with VEPA and PEP-VP regimens were carried out, and adrenal tumor became remarkably small in size. However, adrenal function did not recover. He relapsed in Jan. 1987 and died of multiple organ failure.