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06:08
A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
Adrenal lymphoma: presentation, management and prognosis
C Laurent1, O Casasnovas2, L Martin3
1From the Department of Endocrinology, University Hospital of Dijon, Dijon, France.
QJM : Monthly Journal of the Association of Physicians
|November 1, 2016
Summary
Primary adrenal lymphoma (PAL) often presents with severe general symptoms and adrenal insufficiency, especially in bilateral cases. Diagnosis requires advanced imaging like PET scans, as treatment offers limited survival benefits.
Area of Science:
- Oncology
- Endocrinology
- Radiology
Background:
- Primary adrenal lymphoma (PAL) is a rare malignancy.
- Accurate diagnosis and prognostic features are crucial for patient management.
Purpose of the Study:
- To identify clinical, radiological, and prognostic features of PAL.
- To improve the diagnostic accuracy of primary adrenal lymphoma.
Main Methods:
- Retrospective multi-center study.
- Analysis of clinical, biological, radiological features, treatment, and survival outcomes in 28 PAL patients (1994-2014).
Main Results:
- Common symptoms include general decline, weight loss, and abdominal pain.
- Elevated LDH, β2 microglobulin, CRP, and ferritin were frequent.
- Bilateral involvement occurred in 71% of cases; adrenal insufficiency in 73% of tested patients.
- CT showed large masses; MRI revealed T1 hypointense and T2 hyperintense lesions.
- FDG-PET identified extra-adrenal sites in 70% of cases.
- Adrenalectomy provided no survival benefit; 2-year survival was 61.9% despite chemotherapy.
Conclusions:
- PAL presents with significant systemic symptoms and frequent adrenal insufficiency, particularly with bilateral disease.
- FDG-PET is effective for detecting extra-adrenal involvement.
- MRI shows promise in differentiating PAL from adrenocortical carcinoma, requiring further validation.
- Optimal management strategies for PAL necessitate further investigation.
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