Abstract
Bilateral primary adrenal lymphoma is rare with no specific clinical or imaging features. We report herein the case of a 44-year-old man presenting with massive bilateral adrenal tumors associated with normal adrenal function. Computed tomography findings were nonspecific. Because pheochromocytoma was ruled out and the patient had a normal coagulation test, we performed an ultrasound-guided adrenal biopsy for diagnostic purposes. Pathology confirmed adrenal non-Hodgkin's lymphoma. By reporting our case, we aimed to propose a practical approach for this rare entity and to show that there are still situations in which biopsy is necessary to make a diagnosis.
Highlights
Primary adrenal lymphoma (PAL) is rare with no strict definition and is rarely suspected in bilateral adrenal masses due to the absence of specific clinical or imaging features.[1],[2],[3] This presents a diagnostic challenge
Authors report the case of a 44-year-old man with a PAL presenting as massive bilateral adrenal tumors associated with normal adrenal function
We aimed to propose a practical approach for this rare entity and showed the feasibility of adrenal ultrasound-guided biopsy
Summary
Primary adrenal lymphoma (PAL) is rare with no strict definition and is rarely suspected in bilateral adrenal masses due to the absence of specific clinical or imaging features.[1],[2],[3] This presents a diagnostic challenge. Authors report the case of a 44-year-old man with a PAL presenting as massive bilateral adrenal tumors associated with normal adrenal function. CT scan of the abdomen and pelvis revealed huge masses in bilateral adrenal area. These masses were necrotic in their center and had regular contours. Because pheochromocytoma was ruled out and the patient had a normal coagulation test, we performed an ultrasound-guided adrenal biopsy for diagnostic purposes. The diagnosis of bilateral PAL was confirmed, in view of no prior history of lymphoma, the poor involvement of Bilateral Adrenal Lymphoma lumbo-aortique lymph nodes, and the negative bone marrow biopsy. As surgery is not recommended in these patients, we referred the patient to an oncologist for further chemotherapy and follow-up
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