Successful Treatment of Primary Adrenal Non-Hodgkin's Lymphoma Associated with Adrenal Insufficiency

Kuyama, Ayako; Takeuchi, Makoto; Munemasa, Mitsuru; Tsutsui, Kunihiko; Aga, Naoko; Goda, Yoshinori; Kanetada, Kenji

doi:10.3109/10428190009060336

Cited by 15 publications

(10 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Bilateral adrenal involvement of PAL is frequently accompanied by clinical adrenal insufficiency [3,4,17-22]. In our series, clinically definite adrenal insufficiency was seen in only one of the five cases in whom the adrenal function was examined.…”

Section: Discussionmentioning

confidence: 47%

Clinicopathological analysis of primary adrenal diffuse large B-cell lymphoma: effectiveness of rituximab-containing chemotherapy including central nervous system prophylaxis

et al. 2013

View full text Add to dashboard Cite

BackgroundPrimary adrenal lymphoma (PAL) is an extremely rare subtype of extranodal non-Hodgkin’s lymphoma. Some researchers have reported some of the characteristics of PAL and its association with poor prognosis; however, the clinicopathological features of PAL remain to be elucidated.MethodsFrom 2008 to 2011 we experienced seven cases of PAL in our institutions. We retrospectively analyzed the clinical and pathological features of these patients.ResultsThe patients ranged in age from 50 to 85 years, with a median of 71 years. The overall male:female ratio was 6:1. All seven patients were diagnosed with diffuse large B-cell lymphoma (DLBCL) pathologically. Bilateral adrenal involvement was confirmed in five patients. The median largest tumor diameter at diagnosis was 58 mm. The Ki-67 index was generally high (>70%). All patients were treated with rituximab-containing chemotherapy, and central nervous system (CNS) prophylaxis was conducted for three patients. One patient with CNS involvement at the time of the diagnosis also received whole-brain radiation. The overall survival rate at two years was 57% (median follow-up; 24.8 months). It is noteworthy that the three patients who received a full course of the rituximab-containing regimen and CNS prophylaxis are currently alive without disease relapse, and that none of the seven patients died due to progression of lymphoma.ConclusionsPrimary adrenal DLBCL can be a clinically aggressive disease entity. Rituximab-containing chemotherapy combined with CNS prophylaxis could be a reasonable option for the treatment of PAL; however, analyses of more PAL cases are needed for the establishment of this strategy.

show abstract

Section: Discussionmentioning

confidence: 47%

Clinicopathological analysis of primary adrenal diffuse large B-cell lymphoma: effectiveness of rituximab-containing chemotherapy including central nervous system prophylaxis

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Thus, we concluded that the current case is histologically diagnosed as primary adrenal DLBCL. In recent cases, (R)-CHOP has been the standard treatment as performed in this case (23)(24)(25). A poor prognosis is thought to be due to advanced age at diagnosis, large tumor size, increased LDH levels, and adrenal insufficiency at the time of presentation, indicating extensive adrenal destruction (7).…”

Section: A) B)mentioning

confidence: 99%

Primary Bilateral Adrenal Diffuse Large B-cell Lymphoma Demonstrating Adrenal Failure

et al. 2010

View full text Add to dashboard Cite

Primary adrenal lymphoma (PAL) is extremely rare although involvement of malignant lymphoma into adrenals is common. We report a case of a 58-year-old man with bilateral PAL who demonstrated adrenal insufficiency. Primary large B-cell lymphoma was proven by a computed tomography-guided needle biopsy of the adrenal tumor. Although a complete remission was once achieved by combination chemotherapy plus rituximab, a recurrence occurred with brain metastasis leading to his death. We concluded that PAL should be considered as a possible cause of bilateral adrenal incidentalomas with progressive adrenal insufficiency.

show abstract

“…One study reported that mean overall-survival rate is 15.3 months; 34 months of the patients who achieve a partial or complete remission after chemotherapy and 3.6 months of the patients who have no response to chemotherapy [8]. The longest survival was 50 months in cases of treating with CHOP chemotherapy [13]. rubicin, prednisone, methotrexate, bleomycin) [9].…”

Section: Discussionmentioning

confidence: 99%

“…Primary malignant lymphomas arising in endocrine organs are rare with representing only 3% of extranodal lymphomas [8]. They are almost confined to the thyroid gland [5,12] Adrenal insufficiency is rare because it becomes apparent when approximately 90% of adrenal cortex is destructed [13]. And most of adrenal insufficiency are believed to be associated with atrophy of adrenal glands, secondary to autoimmune mechanisms [14].…”

Section: Discussionmentioning

confidence: 99%

Primary Bilateral Adrenal Non-Hodgkin's Lymphoma Presented with Adrenal Insufficiency: A Case Report

Lee

Kim

et al. 2011

Endocrinol Metab

View full text Add to dashboard Cite

Primary adrenal lymphoma is a very rare disease and it is known to have a poor prognosis. We report here on a case of primary adrenal insufficiency that was secondary to primary bilateral adrenal lymphoma. A 54-year old man was hospitalized because of easy fatigability, weight loss and consistent malaise for 6 months. The physical examination revealed hyperpigmentation on the anterior chest and hypotension. According these findings and symptoms, we did a rapid ACTH stimulation test with a clinical suspicion of adrenal insufficiency. He showed an inadequate adrenal response and so he was diagnosed with adrenal insufficiency. The abdominal CT images showed bilateral huge adrenal masses and increased uptake of the adrenal glands on PET. The pathologic diagnosis by ultrasound-guided gun biopsy of the right adrenal gland was diffuse large B cell lymphoma. The patient was administered combination chemotherapy with the R-CHOP regimen, and after 8-cycles of chemotherapy, he achieved complete remission of tumor according to the image studies and he recovered his adrenal function. Primary adrenal lymphoma, although a rare disease, should be considered in patients with bilateral enlargement of the adrenal glands and when the adrenal glands show increased uptake on a PET scan, and especially there is adrenal insufficiency. (Endocrinol Metab 26:101-105, 2011)

show abstract

Successful Treatment of Primary Adrenal Non-Hodgkin's Lymphoma Associated with Adrenal Insufficiency

Cited by 15 publications

References 8 publications

Clinicopathological analysis of primary adrenal diffuse large B-cell lymphoma: effectiveness of rituximab-containing chemotherapy including central nervous system prophylaxis

Clinicopathological analysis of primary adrenal diffuse large B-cell lymphoma: effectiveness of rituximab-containing chemotherapy including central nervous system prophylaxis

Primary Bilateral Adrenal Diffuse Large B-cell Lymphoma Demonstrating Adrenal Failure

Primary Bilateral Adrenal Non-Hodgkin's Lymphoma Presented with Adrenal Insufficiency: A Case Report

Contact Info

Product

Resources

About