Radiology–pathology conference: primary adrenal lymphoma

Tanpitukpongse, Teerath Peter; Kamalian, Shahmir; Punsoni, Michael; Gupta, Mala; Katz, Douglas S.

doi:10.1016/j.clinimag.2011.08.022

Cited by 7 publications

(2 citation statements)

References 17 publications

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“…Almost all previous reports have illustrated that durable remission after systemic chemotherapy is rare with higher incidence of disease recurrence in either primary site or CNS, despite a good initial response. [1,4,5,8,10,12,16,19–23] A recent review showed poor prognosis for PAL with 3-, 6-, and 12-month survival rates of only 67%, 46%, and 20% of patients, respectively. [4] However, in our series, an OS plateau still existed, indicating that patients achieving CR or stable PR would have a better outcome.…”

Section: Discussionmentioning

confidence: 99%

Systemic and prophylactic intrathecal chemotherapy for primary adrenal lymphoma

Liu¹,

Sun

Jiang³

et al. 2019

Medicine

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Primary adrenal lymphoma (PAL) is a rare entity of lymphoma with dismal prognosis using systemic chemotherapy. More clinical reports are needed to guide the treatment for PAL. We performed a retrospective analysis of 20 patients diagnosed with PAL who presented to our center between January 2005 and January 2014. Median age at presentation was 48 years (range: 27–73) with a male-to-female ratio of 7:3. Bilateral and right-sided adrenal involvement were seen in 11 of 20 and 7 of 20 patients, respectively. Adrenal insufficiency (AI) was seen in 6 of 10 evaluated patients. Diffuse large B cell lymphoma (DLBCL) was the most common immunophenotype (85.0%). Two patients died due to rapid disease progression before treatment. Two patients received autologous stem cell transplantation as consolidation therapy. All patients received prophylactic intrathecal chemotherapy. The estimated 5-year overall survival (OS) and progression-free survival (PFS) were 52.5% [95% confidence interval (95% CI: 28.2–72.0)] and 53.2% (95% CI: 29.0–72.5), respectively. These findings suggest that PAL should always be considered in differential diagnosis of adrenal mass with AI. Despite the contrasting previous reports, long-term prognosis of PAL is not necessarily inferior to that of non-Hodgkin lymphoma in general.

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Section: Discussionmentioning

confidence: 99%

Systemic and prophylactic intrathecal chemotherapy for primary adrenal lymphoma

Liu¹,

Sun

Jiang³

et al. 2019

Medicine

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“…The age factor is related to the prognosis, the higher the age, the worst the prognosis [11]. According to reports, the average survival time is 15 months, lower than DLBCL on other organs, the reasons could be the larger size of the tumor, the rearranging of the BCL-6 gene, the rich supply of sinusoids and the complex endocrine function might be related [12].…”

Section: Treatmentmentioning

confidence: 99%

Bilateral Adrenal Primary Diffuse Large B-Cell Lymphoma not Accompanied by Adrenal Insufficiency: A Report of Two Cases

Zheng¹,

Wang²,

Jiang³

et al. 2017

Chemotherapy (Los Angel)

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Abstract:Primary adrenal lymphoma (PAL) is uncommon in clinical settings, which is considered a rare high grade malignant lymphoma with a poor prognosis, patients with bilateral mass are rarer, and patients with normal adrenal function are extremely rare. We present 2 cases of patients with bilateral adrenal primary diffuse large B-cell lymphoma (PA-DLBCL) whose adrenal functions were normal. 2 patients were treated with unilateral adrenalectomy and a combination of chemotherapy. We summarized cases, reviewed the literature and discussed important issues with regard to the pathology change, diagnosis, treatment and prognosis. Keywords: Bilateral primary adrenal lymphoma; Diffuse large B-cell lymphoma Case Report 1A 64-year-old man was admitted into hospital because of bilateral adrenal mass were found during a body check-up. There are not special history of present illness and previous medical history in this patient, such as hypertension, diabetes, and other tumors, and there are not similar relevant diseases in his families. On examination: blood pressure 166/88 mmHg, heart rate 88/min, respiration rate 21/min, superficial lymph nodes swelling (-), heart, lungs, abdominal pathological sign (-). Lab findings: routine blood and urine check were normal; liver and kidney function and electrolytes level were normal; the blood glucose was 6.4 mmol/L (normal: 3.9-6.1mmol/L); Aldosterone 74.02 pg/ml (normal: 73-239 pg/ml); Cortisol 330.34 nmol/L; ACTH 80.38 pg/ml; urine VMA divided into three times as 5.13, 6.41, 3.20 mg/24h. CXR: no abnormalities. Abdominal ultrasound: hypoechoic solid mass revealed on bilateral adrenal gland, right side 13 cm × 10 cm × 5 cm, left side 8.5 cm × 6 cm × 6.5 cm. CT scanhomogenous soft tissue mass on both adrenal area and entirely replacing adrenal gland, CT scan done with contrast enhancements was not obvious changes, right side 13 cm × 10 cm × 5 cm, left side 8.5 cm × 6 cm × 6.5 cm ( Figures 1A-1C Microscope examination: diffuse distribution of tumor, similar rounded size, small amount of nuclear shaped cytoplasm could be observed scattered around the tumor cells. IHC: Bcl1-2 (+), Bcl-6 (weak+), CD20 (+), MUM-1 (+), CD3 (reactive T+), CD43 (partly+), CD138 (-), Kappa (-), Ki-67 (+70%), Lambda (+), CydinD1 (-), Mpo (-) ( Figures 3A and 3B). Surgical findings: Tumor found above kidney, right kidney obviously displaced downwards by compression, renal pedicle vessel are displaced by tumor, proximal to the vena cava, medium in texture, poor blood supply, no obvious adhesion with surrounding tissues, size 13 cm × 10 cm × 5 cm, no swollen lymph nodes were observed around tumor, Complete tumor resection. Left side did not undergo surgery. Post operation therapy: chemotherapy with CHOP (cyclophosphamide, adriamycin, vincristine, and prednisolone). Follow up in 9 months. Case Report 2A 77-year-old man was admitted to our hospital with a 3-month history of abdominal pain .There are not similar relevant diseases in his patients' families. Previous medical history was unremarkable other than sligh...

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Leukemia and Lymphoma

2015

Diagnostic Imaging: Gastrointestinal

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Radiology–pathology conference: primary adrenal lymphoma

Cited by 7 publications

References 17 publications

Systemic and prophylactic intrathecal chemotherapy for primary adrenal lymphoma

Systemic and prophylactic intrathecal chemotherapy for primary adrenal lymphoma

Bilateral Adrenal Primary Diffuse Large B-Cell Lymphoma not Accompanied by Adrenal Insufficiency: A Report of Two Cases

Leukemia and Lymphoma

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