Exp Clin Endocrinol Diabetes 2006; 114(3): 140-144
DOI: 10.1055/s-2005-865913
Case Report

J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

A Primary Adrenal Non-Hodgkin's Lymphoma Presenting as an Incidental Adrenal Mass

R. Libè1 , C. Giavoli1 , L. Barbetta2 , C. Dall'Asta2 , E. Passini1 , R. Buffa3 , P. Beck-Peccoz1 , B. Ambrosi2
  • 1Institute of Endocrine Science, University of Milan, Ospedale Maggiore IRCCS, Milan, Italy
  • 2Istituto Policlinico San Donato, Milan, Italy
  • 3Institute of Pathology, University of Milano Bicocca, Monza, Italy
Further Information

Publication History

Received: March 23, 2005 First decision: June 12, 2005

Accepted: July 8, 2005

Publication Date:
25 April 2006 (online)

Abstract

The primary adrenal localization of a non-Hodgkin's lymphoma (NHL) is a rare event. We report the case of a 70-yr-old woman, who was admitted at our Institute for a hormonal evaluation after the incidental discovery of a right adrenal mass during ultrasonography (US) performed for cardiovascular disease. At the physical examination, no sign of adrenal hyperfunction was present. She showed only an androgenetic alopecia and her blood pressure was 180/70 mm Hg, with an arrhythmic heart rate of 100 beats/min. No alterations in hormonal and biochemical data were observed. US studies showed a right adrenal mass (major diameter 16 mm), and an abdominal computed tomography (CT) scan confirmed this solid lesion (major diameter 15 mm) with a high density. [75Se] methylnorcholesterol adrenal scintigraphy exhibited a normal symmetrical radiotracer uptake. After 8 months of follow-up, an abdominal CT scan demonstrated a significant increase of the right adrenal mass (major diameter: 40 mm), with a solid tissue density and enhancement after i.v. contrast. [75Se] methylnorcholesterol adrenal scintigraphy showed an absent uptake on the right side versus the contralateral side. The hematological, hormonal and radiological evaluation did not reveal any sign of malignancy. Owing to the mass enlargement and the modification of scintigraphic pattern, the patient underwent unilateral adrenalectomy. Histological examination revealed a primary diffuse large B-cell NHL (REAL classification) of the adrenal gland. After surgery, she underwent a combined polychemotherapy (cyclophospamide, adriamycin, vincristine and prednisone) and subsequently one cycle of radiotherapy. At present, the patient is in good conditions and there are no signs or symptoms of recurrent disease.

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MD B. Ambrosi

Istituto Policlinico San Donato

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Italy

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Email: bruno.ambrosi@unimi.it