Primary adrenal lymphoma: three case reports and review of Japanese cases

“…The incidence of PAL is rather low, and it is reported to be less than 1% of that in non‐Hodgkin's lymphoma. Diffuse large B‐cell lymphoma, accounting for 78% of all cases, is the most common type of PAL with most of them being Bcl‐6 rearrangement and non‐germinal type, and bilateral lesions account for 50% to 70% . Primary adrenal lymphoma usually occurs in the old, with an average age of 70 years.…”

Section: Discussionmentioning

confidence: 99%

Adrenal diffuse large B‐cell lymphoma with high PD‐L1 expression: Two case reports and literature review

Chen

et al. 2020

Clinical Laboratory Analysis

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In case one, Hong XX, A 73-year-old female was admitted to another hospital due to the abdominal pain in the right lumbar region in October 2018. The abdominal ultrasonography showed hypoechoic nodule at both adrenal glands, which was about 48 × 18 mm and 32 × 15 mm, respectively. The blood routine revealed: WBC 2.90 × 10 9 /L (normal range: 4-10 × 10 9 /L), Hb 104 g/L (normal range: 110-150 g/L), and PLT 113 × 10 9 /L (normal range: 100-300 × 10 9 /L). The record of baseline adrenal function was missing. The biochemical profile revealed: LDH 241 U/L (normal range: 135-225 U/L) and albumin 33.5 g/L (normal range: 40-55 g/L). The test for Epstein-Barr virus DNA was negative. Positron emission tomography-computed tomography (PET-CT) showed the hyperplasia region of FDG metabolism at bilateral adrenal glands (SUV value = 32), right pleural (SUV = 20.7), and metastatic lymph nodes in the right hilum of the lung and porta hepatis. The adrenal pathology revealed: CD20(+), CD79a(+), MUM-1(+), CD3(−), C-myc(30%+), CD10(−), BCL-2(+), BCL-6(+), and Ki-67(50%+). The patient was finally diagnosed as bilateral adrenal diffuse large B-cell lymphoma (DLBCL) (IV group in Ann Arbor system stage and 3 points in IPI score). Then, R-CHOP regimen for two courses was administered since November 20, 2018, and R-EPOCH regimen for another two courses because of the abdominal ultrasonography showed hypoechoic nodule in the right adrenal gland had not decreased. After that, another PET-CT on May 30, 2019, showed that the hyperplasia region of FDG metabolism in Abstract Background: Primary adrenal lymphoma (PAL) is an infrequent malignant disease and there is no consensus classification or specialized treatment for it. However, PAL has been observed to have worse prognosis compared with other extrarenal malignant lymphomas and diffuse large B-cell lymphoma presents as the most common subtype of PAL. Methods: The current study reported two cases of adrenal diffuse large B-cell lymphoma with high PD-L1 expression and discussed the clinical significance of PD-L1 through literature review.Key Results: The PD-L1 expression rate of the two cases was 90% and 80%, respectively, which was significantly higher than those reported in the literature. Conclusion:PAL is a type of non-Hodgkin's lymphoma with low incidence and poor prognosis, and it is necessary to further explore the early use of immunological checkpoint inhibitors for patients with higher expression of PD-L1 and with rituximab-resistance. K E Y W O R D Sadrenal lymphoma, diffuse large B-cell lymphoma, PD-L 1

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Primary adrenal lymphoma: three case reports and review of Japanese cases

Cited by 2 publications

References 11 publications

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Adrenal diffuse large B‐cell lymphoma with high PD‐L1 expression: Two case reports and literature review

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