Bu Nan, Wu Honghua, Yao Jun, Zhang Junqing, Gao Yanming, Guo Xiaohui
Department of Endocrinology, Peking University First Hospital, Beijing 100034, China.
Department of Endocrinology, Peking University First Hospital, Beijing 100034, China. Email:
Zhonghua Nei Ke Za Zhi. 2015 Jan;54(1):22-6.
To elaborate the clinical characteristics of adrenal non-Hodgkin's lymphoma and to expand the clinical thinking of adrenal tumors.
Subjects with adrenal tumors and non-Hodgkin's lymphomas between January. 1994 and December.2012 in Peking University First Hospital retrospectively were included and these with adrenal lymphoma patients were analyzed in the present study.
Among 1100 adrenal tumors and 1 002 non-hodgkin's lymphomas, 21 patients (aged 35 to 80 years, mean 56 years) were diagnosed as having adrenal non-Hodgkin's lymphoma with 14 males and 7 females. Among the 21 patients, 15 were with pain on the waist and the back, 3 with fever, 1 had weight loss. Two patients were diagnosed by regular health examination. Only 2 subjects accompanied by superficial lymph node enlargement, while 10 by abdominal cavity lymph node enlargement.Eleven subjects were with extranodal involvement. Bilateral adrenal were involved in 8 patients with 9 on the left and 4 the right. The average diameter of the masses was 7.2 cm. There were no specific features in conventional imaging such as CT and MRI scan. All of the 21 cases were found normal adrenal function by endocrinological examinations. Pathology reviewed that 18 of 21 were diffuse large B cell non-Hodgkin's lymphoma, 2 were T cell lymphoma, 1 were anaplastic large cell lymphoma. Only 7 of 21 cases were diagnosed with adrenal lymphoma pre-operation. Seventeen patients were followed up by telephone in September 2014, in which 14 died and the average survival time was 5.5 months, 2 were tumor-free survival for 4 and 10 months respectively, 1 were currently undergoing chemotherapy.
Adrenal lymphoma is rare with less superficial lymph node, more bilateral adrenal involved with high malignant degree. It progressed quickly with poor prognosis. Clinical and imaging features were not specific, so misdiagnosis was very common. Pathology is the diagnostic gold standard. The most common type was diffuse large B cell type.
阐述肾上腺非霍奇金淋巴瘤的临床特点，拓展肾上腺肿瘤的临床思维。
回顾性纳入1994年1月至2012年12月在北京大学第一医院就诊的肾上腺肿瘤及非霍奇金淋巴瘤患者，并对其中肾上腺淋巴瘤患者进行分析。
在1100例肾上腺肿瘤和1002例非霍奇金淋巴瘤患者中，21例（年龄35至80岁，平均56岁）被诊断为肾上腺非霍奇金淋巴瘤，其中男性14例，女性7例。21例患者中，15例有腰背部疼痛，3例发热，1例体重减轻。2例通过常规健康体检确诊。仅2例伴有浅表淋巴结肿大，10例伴有腹腔淋巴结肿大。11例有结外受累。8例双侧肾上腺受累，左侧9例，右侧4例。肿块平均直径7.2 cm。CT和MRI等传统影像学检查无特异性表现。21例患者内分泌检查肾上腺功能均正常。病理检查显示，21例中18例为弥漫大B细胞非霍奇金淋巴瘤，2例为T细胞淋巴瘤，1例为间变性大细胞淋巴瘤。21例中仅7例术前诊断为肾上腺淋巴瘤。2014年9月对17例患者进行电话随访，其中14例死亡，平均生存时间5.5个月，2例无瘤生存分别为4个月和10个月，1例正在接受化疗。
肾上腺淋巴瘤罕见，浅表淋巴结受累少，双侧肾上腺受累多，恶性程度高，进展快，预后差。临床及影像学表现无特异性，误诊常见。病理是诊断的金标准。最常见类型为弥漫大B细胞型。
