Bilateral adrenal non-Hodgkin lymphoma type B

• Published in: Journal of endocrinological investigation Vol. 26; no. 11; pp. 1120 - 1123
• Main Authors: TUMINO, S, LEOTTA, M. L, BRANCIFORTE, G, MANTERO, F, CALOGERO, A. E
• Format: Journal Article
• Language: English
• Published: Milano Kurtis 01.11.2003
• Subjects: Adrenal Gland Neoplasms - diagnostic imaging; Adrenal Gland Neoplasms - drug therapy; Adrenal Gland Neoplasms - pathology; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Endocrinopathies; Fatal Outcome; Female; Fundamental and applied biological sciences. Psychology; Humans; Lymphoma, B-Cell - diagnostic imaging; Lymphoma, B-Cell - drug therapy; Lymphoma, B-Cell - pathology; Lymphoma, Large B-Cell, Diffuse - diagnostic imaging; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - pathology; Medical sciences; Tomography, X-Ray Computed; Ultrasonography; Vertebrates: endocrinology; Bilateral; Malignant hemopathy; Adrenal glands; Non Hodgkin lymphoma; Lymphoproliferative syndrome; Endocrinology
• ISSN: 0391-4097; 1720-8386
• DOI: 10.1007/BF03345261

The adrenal localization of a primary non-Hodgkin lymphoma (NHL) is rare. We report a case of a 66-yr-old woman who had severe asthenia, diffuse skin hitching and abdominal pain. The physical examination revealed poor general conditions, irritability, pallor, dehydration and diffuse skin scratching lesions. The abdomen was painful at left hypochondrium and the Giordano's maneuvre was positive on both sides. A peripheral blood smear showed the presence of big rare lymphocytes with dyshomogeneous chromatin and granulated and hyperbasophil cytoplasm. She underwent abdominal ultrasonography which showed the presence of a hypoechogenic ovoidal mass (major diameter 8.4 cm) within the splenorenal left region. The presence of the suprarenal mass was confirmed by computed tomography (CT) scan which showed an enlarged left adrenal gland (8.1 x 6.2 cm) of solid structure. The right adrenal gland was also enlarged and of round shape (4.5 cm). CT scan-guided fine needle aspiration biopsy was then carried out on the left adrenal mass. It revealed the presence of NHL type B with large cells and modest T-lymphocyte reactive component. The patient was treated with three cycles of cyclophosphamide, adriamycin, vincristine and prednisolone. At the end of the third cycle, there was a transient clinical improvement and the hitching disappeared, but the patient worsened rapidly and she died few weeks later.