Toogood Vanita, Milliken Sam, Morey Adrienne, Samaras Katherine
Department of Endocrinology, St Vincent's hospital, Darlinghurst, New South Wales, Australia.
Department of Haematology, St Vincent's Hospital, Sydney, Australia.
BMJ Case Rep. 2014 Dec 23;2014:bcr2014203736. doi: 10.1136/bcr-2014-203736.
Adrenal masses are commonly found in the course of abdominal investigations and present diagnostic challenges. The foremost issue is whether the mass is the cause of the symptoms being investigated. Additional important clinical questions are: (1) is the adrenal mass benign or malignant and (2) whether the adrenal mass is functional or non-functional? We present a case of a 48-year-old man with severe abdominal pain. Imaging revealed a very large adrenal mass. Differential diagnostic procedures were performed and a diagnosis of primary adrenal lymphoma, an extremely rare cause of adrenal malignancy, was made. He proceeded to chemotherapy with cyclical cyclophosphamide, doxorubicin, etoposide and prednisolone, in addition to rituximab. This case illustrates the importance of establishing the nature of adrenal masses, to rapidly facilitate appropriate treatment.
肾上腺肿块在腹部检查过程中很常见，并且带来诊断挑战。首要问题是该肿块是否为正在检查的症状的病因。其他重要的临床问题包括：（1）肾上腺肿块是良性还是恶性，以及（2）肾上腺肿块是功能性还是非功能性？我们报告一例48岁男性，患有严重腹痛。影像学检查发现一个非常大的肾上腺肿块。进行了鉴别诊断程序，诊断为原发性肾上腺淋巴瘤，这是肾上腺恶性肿瘤极其罕见的病因。除了利妥昔单抗外，他接受了环磷酰胺、阿霉素、依托泊苷和泼尼松龙的周期性化疗。该病例说明了确定肾上腺肿块性质的重要性，以便迅速促进适当的治疗。
