Primary Adrenal Lymphoma: When B Symptoms Appear Hand in Hand with Adrenal Masses
  • David Lopes Sousa
    Department of Internal Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Sandra D. Santos
    Department of Internal Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • João Pina Cabral
    Department of Internal Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Ricardo Velho
    Department of Internal MediDepartment of Internal Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugalcine, Centro Hospitalar e Universitário de Coimbra
  • Ana Sofia Teixeira
    Department of Internal Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Pedro Ribeiro
    Department of Internal Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

Keywords

Primary adrenal lymphoma, adrenal mass, positron emission tomography

Abstract

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.

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    Published: 2022-01-13
    Issue: 2022: Vol 9 No 1 (view)

    How to cite:
    1.
    Lopes Sousa D, D. Santos S, Pina Cabral J, Velho R, Teixeira AS, Ribeiro P. Primary Adrenal Lymphoma: When B Symptoms Appear Hand in Hand with Adrenal Masses. EJCRIM 2022;9 doi:10.12890/2022_003116.

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