Mainly Adrenal Gland Involving NK/T-Cell Nasal Type Lymphoma Diagnosed with Delay due to Mimicking Adrenal Hemorrhage

Abstract

A 29-yr-old man, presented with abdominal pain and fever, had an initial computed tomography (CT) scan revealing low attenuation of both adrenal glands. The initial concern was for tuberculous adrenalitis or autoimmune adrenalitis combined with adrenal hemorrhage. The patient started empirical anti-tuberculous medication, but there was no improvement. Enlargement of cervical lymph nodes were developed after that and excisional biopsy of cervical lymph nodes was performed. Pathological finding of excised lymph nodes was compatible to NK/T-cell lymphoma. The patient died due to the progression of the disease even after undergoing therapeutic trials including chemotherapy. Lymphoma mainly involving adrenal gland in the early stage of the disease is rare and the vast majority of cases that have been reported were of B-cell origin. From this case it is suggested that extra-nodal NK/T-cell lymphoma should be considered as a cause of bilateral adrenal masses although it is rare.

NK/T-cell lymphoma of bilateral adrenal glands in a patient with pyothorax

“…Therefore, this case of non-B-cell lymphoma is a rare case. Six cases of peripheral T-cell lymphoma and five cases of NK/T-cell lymphoma have been reported [ 3 , 4 ]. On the other hand, most pyothorax-associated lymphomas have shown findings of DLBCL occurring in the pleural cavity in addition to strong positive findings of EBV.…”