Abstract

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a subtype of Hodgkin lymphoma (HL), and is a rare disease manifestation in the adrenal gland, which is difficult to be diagnosed and treated. In the present study, we report a case of primary adrenal NLPHL in a 36-year-old male patient. The patient was without specific clinical signs and the definitive diagnosis was achieved by histological study. The patient underwent a laparoscopic left adrenalectomy and chemotherapy regimen of doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD). There is no standard treatment for adrenal NLPHL and therefore, treatment is based on that for other types of NLPHL, which includes radiotherapy and ABVD chemotherapy. Given the rarity of this disease, there are limited experiences with regard to its diagnosis and treatment. This study is useful for the differential diagnosis and treatment of adrenal masses.

Highlights

  • The majority of adrenal lesions are benign adrenal cortical adenomas

  • We report a unique case of nodular lymphocyte‐predominant Hodgkin lymphoma (NLPHL) affecting only the adrenal gland in a patient who was successfully diagnosed by histological examination, and treated with surgery and a chemotherapy regimen of doxorubicin, bleomycin, vinblastine and dacarbazine

  • Immunohistochemical analysis showed that the tumor cells were negative for cluster of differentiation 30 (CD30) and Epstein‐Barr virus (EBV)‐encoded small RNAs (EBERs), and positive for CD20, WANG et al: PRIMARY ADRENAL NODULAR LYMPHOCYTE-PREDOMINANT HODGKIN LYMPHOMA

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Summary

Introduction

Nodular lymphocyte‐predominant Hodgkin lymphoma (NLPHL) is a rare disease manifestation in the adrenal gland. NLPHL is a subtype of Hodgkin lymphoma (HL), which represents ~5% of HLs and involves peripheral lymph nodes. Secondary aggressive non-Hodgkin lymphoma may occur in ~7–14% of NLPHL cases, but the majority of NLPHL patients present at an early stage and have a favourable prognosis [3,4,5,6]. The peripheral and most commonly the cervical regions are involved [1,2]. B symptoms, extranodal involvement and bulky disease are uncommon [7]. We report a unique case of NLPHL affecting only the adrenal gland in a patient who was successfully diagnosed by histological examination, and treated with surgery and a chemotherapy regimen of doxorubicin, bleomycin, vinblastine and dacarbazine.

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