Primary adrenal diffuse large B cell lymphoma: a clinicopathological and molecular study from China

Area of Science:

• Oncology
• Hematology
• Pathology

Background:

• Primary adrenal lymphoma is a rare malignancy, predominantly B-cell in origin.
• Diffuse large B cell lymphoma (DLBCL) is the most frequent type of primary adrenal lymphoma.

Purpose of the Study:

• To investigate the clinicopathological and molecular characteristics of primary adrenal DLBCL in Chinese patients.
• To analyze patient presentation, tumor subtypes, and prognostic factors.

Main Methods:

• Retrospective review of 14 Chinese patients with primary adrenal DLBCL.
• Utilized immunohistochemistry, immunoglobulin gene rearrangement analysis, Epstein-Barr virus (EBV) status evaluation, and fluorescence in situ hybridization.
• Classified DLBCL subtypes using the Hans algorithm and assessed Ki-67 proliferation index.

Main Results:

• The mean patient age was 58 years, with common symptoms including abdominal pain and adrenal mass.
• 13 out of 14 cases were DLBCL not otherwise specified, predominantly the non-germinal center B-cell-like subtype (13/14).
• Epstein-Barr virus-encoded RNA was detected in 6/12 cases, and BCL-6 rearrangements were found in 2 patients. High Ki-67 index (35-80%) indicated high proliferative activity.

Conclusions:

• Primary adrenal lymphomas are frequently non-germinal center B-cell-like subtype DLBCLs with high proliferative rates.
• These tumors are associated with a poor prognosis, necessitating further research into treatment strategies.