DOI: 10.12890/2022_003116

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

Authors

  • 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

davidlopesousa@gmail.com

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.

View the entire article

Downloads

References

  1. Rashidi A, Fisher SI. Primary adrenal lymphoma: a systematic review. Ann Hematol 2013;92(12):1583–1593. doi: 10.1007/s00277-013-1812-3.
  2. Wang Y, Ren Y, Ma L, Li J, Zhu Y, Zhao L, et al. Clinical features of 50 patients with primary adrenal lymphoma. Front Endocrinol (Lausanne) 2020;11:595. doi: 10.3389/fendo.2020.00595.
  3. Laurent C, Casasnovas O, Martin L, Chauchet A, Ghesquieres H, Aussedat G, et al. Adrenal lymphoma: presentation, management and prognosis. QJM 2017;110(2):103–109. doi: 10.1093/qjmed/hcw174.
  4. de Sousa Lages A, Bastos M, Oliveira P, Carrilho F. Diffuse large B-cell lymphoma of the adrenal gland: a rare cause of primary adrenal insufficiency. BMJ Case Rep 2016;2016:bcr2016214920. doi: 10.1136/bcr-2016-214920.
  5. Ferreira R, Moniz C, Serra F, Fonseca R, Simões H, Oliveira M, et al. Primary lymphoma of bilateral adrenal. Rev Port Endocrinol Diabetes Metab 2014;9:149–152.

Published

2022-01-13

Issue

Vol. 9 No. 1 (2022)

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 [Internet]. 2022 Jan. 13 [cited 2026 Nov. 4];9(1). Available from: https://ejcrim.com/index.php/ejcrim/article/view/3116

Most read articles by the same author(s)