Preview

Journal of radiology and nuclear medicine

Advanced search

Primary Diffuse Large B-Cell Lymphoma of the Adrenal Glands: a Rare Cause of Paraneoplastic Neuropathy

https://doi.org/10.20862/0042-4676-2024-105-2-87-92

Abstract

The article presents a detailed analysis of clinical observation of primary diffuse large B-cell lymphoma of the adrenal glands, a rare disease affecting less than 1% of patients with non-Hodgkin’s lymphomas. It describes the case of a 46-year-old man hospitalized with progressive limb paralysis, later diagnosed as paraneoplastic polyradiculoneuropathy associated with bilateral adrenal lymphoma. The diagnostic challenges of this pathology, including ambiguous imaging results and the need for histological verification to confirm the diagnosis are discussed. Special attention is paid to the uniqueness of clinical manifestations and the importance of early symptom recognition to improve prognostic outcomes in highly aggressive forms of the disease. The necessity of multidisciplinary approach in managing such patients with the participation of oncologists, endocrinologists, and neurologists to optimize diagnostic and therapeutic processes is also emphasized.

About the Authors

D. V. Shestakov
Karaganda Medical University
Kazakhstan

Dmitriy V. Shestakov, Resident Radiologist

ul. Gogolya, 40, Karaganda, 100000



К. A. Posmetukhova
Karaganda Medical University
Kazakhstan

Кristina А. Posmetukhova, Resident Radiologist

ul. Gogolya, 40, Karaganda, 100000



Ä. Т. Älieva
Karaganda Medical University
Kazakhstan

Äliya Т. Älieva, Resident Radiologist

ul. Gogolya, 40, Karaganda, 100000



References

1. Laurent C, Casasnovas O, Martin L, et al. Adrenal lymphoma: presentation, management and prognosis. QJM. 2017; 110(2): 103–9. https://doi.org/10.1093/qjmed/hcw174.

2. Li S, Wang Z, Wu Z, et al. Clinical characteristics and outcomes of primary adrenal diffuse large B cell lymphoma in a large contemporary cohort: a SEER-based analysis. Ann Hematol. 2019; 98(9): 2111–9. https://doi.org/10.1007/s00277-019-03740-9.

3. Ibrahim S, Thibodeaux R, Mathew M. SAT-233 primary adrenal diffuse large B-cell lymphoma in HIV patient: a rare case report. J Endocr Soc. 2020; 4(Suppl. 1): SAT-233 https://doi.org/10.1210/jendso/bvaa046.687.

4. Ke YL, Hsu JF, Wei YC, Hsiao HH. Unusual bilateral adrenal tumors: primary adrenal diffuse large B-cell lymphoma. J Cancer Res Pract. 2021; 8(1): 36–8. https://doi.org/10.4103/jcrp.jcrp_34_20.

5. Horiguchi K, Hashimoto K, Hashizume M, et al. Primary bilateral adrenal diffuse large B-cell lymphoma demonstrating adrenal failure. Intern Med. 2010; 49(20), 2241–6. https://doi.org/10.2169/internalmedicine.49.3941.

6. Xing Q, Hu C, Zhao Q, et al. Primary adrenal diffuse large B cell lymphoma with tumor thrombus in central adrenal vein: a case report and literature review. BMC Endocr Disord. 2023; 23: 258. https://doi.org/10.1186/s12902-023-01496-y.

7. de Sousa Lages A, Bastos M, Oliveira P, Carrilho F. Diffuse large B-cell lymphoma of the adrenal gland: a rare cause of primary adrenal insufficiency. BMJ Case Rep. 2016; 2016: bcr2016214920. https://doi.org/10.1136/bcr-2016-214920.

8. Jin H, Liao W, Yang S, et al. Clinical features and imaging manifestations for intravascular large B-cell lymphoma. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023; 48(12): 1920–8. https://doi.org/10.11817/j.issn.1672-7347.2023.230305.

9. Kim Y, Kim J, Min Y, et al. Prognostic factors in primary diffuse large B-cell lymphoma of adrenal gland treated with rituximab-CHOP chemotherapy from the Consortium for Improving Survival of Lymphoma (CISL). J Hematol Oncol. 2012; 5: 49. https://doi.org/10.1186/1756-8722-5-49.

10. Majidi F, Martino S, Kondakci M, et al. Clinical spectrum of primary adrenal lymphoma: results of a multicenter cohort study. Eur J Endocrinol. 2020; 183(4): 453–62. https://doi.org/10.1530/EJE-19-0506.

11. Zhou L, Peng W, Wang C, et al. Primary adrenal lymphoma: radiological; pathological, clinical correlation. Eur J Radiol. 2012; 81(3): 401–5. https://doi.org/10.1016/j.ejrad.2010.11.026.

12. Wang Y, Ren Y, Ma L, et al. Clinical features of 50 patients with primary adrenal lymphoma. Front Endocrinol. 2020; 11: 595. https://doi.org/10.3389/fendo.2020.00595.

13. Shim HK, Kim SW. Imaging of F-18 FDG PET/CT and follow up of bilateral invasive adrenal diffuse large B cell lymphoma mimicking adrenocortical carcinoma. Kosin Med J. 2017; 32(2): 269–76. https://doi.org/10.7180/kmj.2017.32.2.269.

14. Mozos A, Ye H, Chuang WY, et al. Most primary adrenal lymphomas are diffuse large B-cell lymphomas with nongerminal center B-cell phenotype, BCL6 gene rearrangement and poor prognosis. Mod Pathol. 2009; 22(9): 1210–7. https://doi.org/10.1038/modpathol.2009.87.

15. Nair SC, Gogia A, Arora S, et al. Clinicopathologic features and outcomes of diffuse large B-cell lymphoma with extranodal involvement: a retrospective analysis. Cancer Res Stat Treat. 2022; 5(1): 67–74. https://doi.org/10.4103/crst.crst_204_21.

16. Yang Y, Xie W, Ren Y, et al. A case report of primary adrenal lymphoma. Medicine. 2020; 99(28): e20938. https://doi.org/10.1097/md.0000000000020938.

17. Chen Y, He SH, Hu QF, Wang G. Adrenal diffuse large B-cell lymphoma with high PD-L1 expression: two case reports and literature review. J Clin Lab Anal. 2020; 34(5): e23173. https://doi.org/10.1002/jcla.23173.

18. Fan ZN, Shi HJ, Xiong BB, et al. Primary adrenal diffuse large B-cell lymphoma with normal adrenal cortex function: a case report. World J Clin Cases. 2022; 10(2): 709–16. https://doi.org/10.12998/wjcc.v10.i2.709.

19. Britto MM, Kang MJY, Goare S, et al. A case of an incidental primary adrenal lymphoma in a patient with newly diagnosed human immunodeficiency virus. ANZ J Surg. 2019; 89(3): E106–8. https://doi.org/10.1111/ans.14078.

20. Rawat S, Haritha VS. Primary adrenal lymphoma. J Cancer Res Cell Ther. 2022; 6(3): 1–3. https://doi.org/10.31579/2640-1053/119.

21. Uysal HB, Duran M, Güney E, et al. A unique case of adrenal insufficiency coexisting with two primary malignancies. Ann King Edward Med Univer. 2023; 29(2), 167–9. https://doi.org/10.21649/akemu.v29i2.5487.


Review

For citations:


Shestakov D.V., Posmetukhova К.A., Älieva Ä.Т. Primary Diffuse Large B-Cell Lymphoma of the Adrenal Glands: a Rare Cause of Paraneoplastic Neuropathy. Journal of radiology and nuclear medicine. 2024;105(2):87-92. (In Russ.) https://doi.org/10.20862/0042-4676-2024-105-2-87-92

Views: 143


ISSN 0042-4676 (Print)
ISSN 2619-0478 (Online)