Shirao Sayaka, Kuroda Hiroyuki, Kida Masaya, Watanabe Hideki, Matsunaga Takuya, Niitsu Yoshiro, Konuma Yu-ichi, Hirayama Yasuo, Kohda Kyuhei
Division of Gastroenterology, Chitose City Hospital.
Rinsho Ketsueki. 2006 Mar;47(3):204-9.
Primary adrenal lymphoma is a rare lymphoma with clinical features consisting of a high incidence of bilateral adrenal involvement, diffuse large B-cell histology and secondary adrenal insufficiency. We report a successful treatment of a patient with primary adrenal lymphoma using a combined modality therapy (CMT). A 62-year-old man was hospitalized with pain of the flank, and a computed tomography (CT) scan of the abdomen revealed very large, bilateral adrenal masses. A needle biopsy of the left adrenal mass revealed diffuse large B-cell lymphoma. After irradiation of both adrenal lymphomas and CHOP therapy accompanied by intrathecal treatment and rituximab, the patient underwent a left adrenalectomy and high-dose chemotherapy with autologous peripheral blood stem cell transplantation. The patient has been disease-free for 2 years after the diagnosis of primary adrenal lymphoma. In contrast to the previous reports of poor response to conventional-dose chemotherapy alone and short-term survival of patients with primary adrenal lymphoma, our patient has demonstrated that radiation therapy combined with chemotherapy and rituximab may be an effective modality as a first-line therapeutic regimen for localized primary adrenal lymphoma.
原发性肾上腺淋巴瘤是一种罕见的淋巴瘤，其临床特征包括双侧肾上腺受累的高发生率、弥漫性大B细胞组织学以及继发性肾上腺功能不全。我们报告了一例采用综合治疗方案（CMT）成功治疗原发性肾上腺淋巴瘤患者的病例。一名62岁男性因胁腹疼痛入院，腹部计算机断层扫描（CT）显示双侧肾上腺有非常大的肿块。左侧肾上腺肿块穿刺活检显示为弥漫性大B细胞淋巴瘤。在对双侧肾上腺淋巴瘤进行放疗以及采用CHOP方案化疗并联合鞘内治疗和利妥昔单抗后，患者接受了左侧肾上腺切除术及自体外周血干细胞移植的大剂量化疗。该患者自原发性肾上腺淋巴瘤诊断后已无病生存2年。与之前关于原发性肾上腺淋巴瘤患者单独使用常规剂量化疗反应不佳及短期生存的报道不同，我们的患者表明，放疗联合化疗及利妥昔单抗可能是局限性原发性肾上腺淋巴瘤一线治疗方案的有效方式。
