CT and MRI features of primary adrenal lymphoma

Abstract

Objective The purpose of this study was to analyze CT and MRI findings of primary adrenal lymphoma in order to enhance the understanding of this rare disease. Methods A group of 5 patients with pathologically proven primary adrenal lymphoma were reviewed. Imaging findings (CT & MRI, n = 3 ; only CT, n = 2) were analyzed and correlated with clinical and pathologic findings. Results There were a total 8 lesions in 5 patients. The maximum diameter of the lesions ranged from 6 to 15 cm. Of the 8 lesions, 2 were round, 3 were oval and 3 were irregular. On coronal MRI, 4 of 6 lesions manifested as triangular. Compared to normal muscle, 2 lesions manifested as slight low-density and 6 lesions manifested as isodensity on unenhanced CT images; 2 lesions showed isointensity and 4 revealed slight hypointensity on T1 WI, all of 6 lesions exhibited hyperintensity on T2 WI. After intravenous injection of contrast media, 6 lesions enhanced slightly and 2 lesions enhanced moderately on CT and MRL 2 lesions were homogeneous, 4 lesions were slightly uneven and 2 were heterogeneous on enhanced CT and MRI. Four lesions infiltrated the ipsilateral kidney and adjacent blood vessels. The maximum diameter 10 cm were seen in 3 of the 4 lesions. These lesions embedded the upper kidneys, renal hilars and adjacent blood vessels. Conclusions Most of the adrenal lymphoma manifested as large soft tissue masses with shght contrast enhancement. The larger lesions were likely to invade the ipsilateral kidney and adjacent blood vessels. Key words: Lymphoma; Adrenal gland; Tomography; X-ray computed; Magnetic resonance imaging