Primary adrenal non-Hodgkin's lymphoma: report of 7 cases
10.3760/cma.j.issn.1000-6702.2009.04.003
- VernacularTitle:原发性肾上腺非霍奇金淋巴瘤七例报告
- Author:
Min FAN
;
Xiaozhou HE
;
Zhifu CHAO
;
Renfang XU
;
Xianlin XU
;
Chunyin YAN
- Publication Type:Journal Article
- Keywords:
Adrenal neoplasms;
Lyrnphoma
- From:
Chinese Journal of Urology
2009;30(4):224-227
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the diagnosis and treatment of primary adrenal lymphoma. Methods The clinical data of 7 adrenal primary lymphoma cases were retrospectively analyzed. Five cases were male,2 were female. Age ranged from 33 to 62 years,mean 48 years. Two cases presented with unilateral and 5 cases with bilateral masses. Two cases were found by regular health examination. Two cases had fever and weakness, with body weight loss for 3-4 months. One case had enlarged testis for 1 month. Two cases had lumbar pain accompanied by enlarged spleen. Abdominal ultra-sonography and CT showed adrenal neoplasms. All 7 cases had elevated serum lactate dehydrogenase (367-568 U/L, normal range 100-245 U/L) and β2 microglobulin (5.9-6.3 mg/L, normal range 2.4 mg/L). The CT showed irregular,inhomogeneous adrenal mass which was mildly enhanced. Results Four of the 7 patients were misdiagnosed before operation. Two patients were diagnosed as adrenal lymphoma by biopsy. One patient was diagnosed by testicular biopsy. One was T cell non-Hodgkin's lymphoma. Six cases were diagnosed as diffuse large B cell non-Hodgkin's lymphoma by pathology. Immunohistochemieally,the tumor cells were positive for CD3,CD45-RO, L26 and CD79a. Four patients had their adrenal mass removed and received chemotherapy afterwards. As follow-up of 2 years, 1 patient had no evidence of recurrence. Three patients died after 2,6,20 months after opera-tion. Three cases took chemotherapy and radiation therapy after diagnosed. They died 19,32, 38 months during follow up. Conclusions Because adrenal mass as the primary representation of prima-ry adrenal lymphoma has no characteristic clinical appearance, diagnosis could not be made preopera-tively. The principal treatment consists of adrenalectomy and adjuvant combination chemotherapy.
