CXCR4 and Cushing syndrome due to macronodular adrenal hyperplasia: In addition, given that increased CXCR4 expression was found in cortisol-producing adenomas16 and patients with Cushing syndrome were reported to show a positive gallium-68 pentixafor PET-CT result in a previous study,45 patients with PA concurrent with Cushing syndrome were excluded in our study.