Introduction: The involvement of certain organs such as the adrenal gland is rare in non-Hodgkins lymphoma (NHL). Although lymphomas can involve virtually all extranodal organs, different organs show different frequency of involvement. Adrenal gland involvement is usually bilateral. We report that a rare case of unilateral adrenal involvement of diffuse large B-cell lymphoma presenting with abdominal pain.
Case: A 64-year-old-man presented with abdominal pain, weakness, weight loss. Abdominal computed tomography (CT) revealed 59×53 mm right adrenal mass, 40×25 mm paraaortic lymphadenopathy, multiple solid mass lesions in the spleen and malignant infiltrating mass lesions in the perineal vascular structures. Surgical lymph node biopsy demonstrated a diffuse large B cell lymphoma. The pathology specimens showed neoplastic infiltration of pleomorphic lymphoid cells with scanty cytoplasm, irregular nuclear contour, large nuclei, with one to three peripherally positioned nucleoli. He was treated with rituximab, cyclophosphamide, doxorubicin and vincristine (R-CHOP). The patient tolerated treatment well without significant side effects. After the six courses chemotherapy, the patients systemic symptoms were improved.
Conclusion: Extranodal organ involvement is more common in non-Hodgkins lymphoma than in Hodgkins lymphoma. Systemic chemotherapy has been regarded as the best therapeutic approach for NHL involving rare extranodal sites. Adrenal involvement of systemic lymphoma should be considered when evaluated the adrenal masses.
20 - 23 May 2017
European Society of Endocrinology