Donckier J E, Lacrosse M, Michel L
Department of Internal Medicine, University Hospital of Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium.
Acta Chir Belg. 2007 Mar-Apr;107(2):219-21.
A 65 year old man presenting with abdominal and back pain was found to have bilateral adrenal masses. Phaeochromocytomas were initially suspected on the basis of increased catecholamine excretion. This diagnosis seemed unlikely in view of clinical findings and a negative 123I-metaiodobenzylguanidine scintigraphy. A biopsy of the right adrenal mass revealed a diagnosis of primary adrenal B-cell lymphoma. Hyponatraemia and subtle clinical signs of adrenal insufficiency led to a diagnosis of Addison's disease, a common complication of primary adrenal lymphoma. Thus, bilateral adrenal masses associated with Addison's disease should raise the suspicion of possible primary adrenal lymphoma.
一名65岁男性因腹痛和背痛就诊，发现双侧肾上腺肿块。最初根据儿茶酚胺排泄增加怀疑患有嗜铬细胞瘤。鉴于临床表现和123I-间碘苄胍闪烁扫描阴性，这一诊断似乎不太可能。右侧肾上腺肿块活检确诊为原发性肾上腺B细胞淋巴瘤。低钠血症和肾上腺功能不全的细微临床体征导致诊断为艾迪生病，这是原发性肾上腺淋巴瘤的常见并发症。因此，与艾迪生病相关的双侧肾上腺肿块应引起对可能的原发性肾上腺淋巴瘤的怀疑。
