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

Autor: David Lopes Sousa, Sandra D. Santos, João Pina Cabral, Ricardo Velho, Ana Sofia Teixeira, Pedro Ribeiro
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: European Journal of Case Reports in Internal Medicine (2022)
Druh dokumentu: article
ISSN: 2284-2594
DOI: 10.12890/2022_003116
Popis: 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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