Primary Adrenal Lymphoma: When B Symptoms Appear Hand in Hand with Adrenal Masses

European Journal of Case Reports in Internal Medicine

Ricardo Velho¹  João Pina Cabral²  Sandra D. Santos²  Pedro Ribeiro²  Ana Sofia Teixeira²  David Lopes Sousa² 

[1] Department of Internal MediDepartment of Internal Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugalcine, Centro Hospitalar e Universitário de Coimbra;Department of Internal Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal;

关键词: primary adrenal lymphoma;    adrenal mass;    positron emission tomography;   

DOI  :  10.12890/2022_003116

来源: DOAJ

【 摘 要 】

Primary adrenal lymphoma (PAL) is a very rare type of non-Hodgkin’s lymphoma (NHL). Herein, we report a case of NHL of both adrenal glands in a 69-year-old man. The patient was admitted because of a 1-month history of B symptoms and symptomatic hypotension. Biochemical analysis showed normocytic normochromic anaemia, hyponatraemia, hyperkalaemia, and elevated lactate dehydrogenase, C-reactive protein and D-dimers. A computed tomography scan revealed bilateral enlargement of the adrenal glands. There was no evidence of endocrine adrenal dysfunction. The mass in the right adrenal gland was biopsied and histopathology identified a diffuse large B-cell lymphoma of the activated B-cell subtype. A positron emission tomography 18F-fluorodeoxyglucose scan showed intensive hypermetabolic lesions involving both adrenal glands, as well as other locations, with higher uptake in the adrenal glands. Taken together, these findings suggested the diagnosis of PAL. The patient responded favourably to debulking therapy and is currently undergoing chemotherapy.

【 授权许可】

Unknown