Primary Adrenal Lymphoma: Two Case Series From China

Area of Science:

• Oncology
• Endocrinology
• Pathology

Background:

• Primary adrenal lymphoma (PAL) is an uncommon adrenal neoplasm.
• Understanding its clinical, radiological, and pathological characteristics is crucial for diagnosis and management.

Purpose of the Study:

• To summarize the clinical presentation, biochemical and radiological features, pathological information, treatment strategies, and outcomes of PAL.
• To identify key diagnostic and prognostic indicators for PAL.

Main Methods:

• Retrospective review of medical records and pathology specimens from patients diagnosed with PAL.
• Data collected included clinical symptoms, biochemical markers, imaging findings (CT, FDG-PET-CT), pathology, treatment, and survival outcomes.

Main Results:

• Twenty-six PAL patients (mean age 60.8 years, M:F 2.25:1) presented with anorexia, weight loss, abdominal pain, and fatigue.
• Elevated LDH, β2-microglobulin, CRP, ferritin, and ESR were common. Bilateral involvement (81%) often led to adrenal insufficiency.
• Diffuse large B-cell lymphoma (DLBCL) was the predominant type (92%). Chemotherapy was the primary treatment, with a poor prognosis (median survival 7.2 months).

Conclusions:

• PAL presents with non-specific symptoms and frequently involves both adrenal glands, potentially causing adrenal insufficiency.
• FDG-PET-CT is valuable for detecting extra-adrenal disease.
• Improved therapeutic strategies are needed to enhance the poor prognosis of PAL.