Department of Radiology, Koç University Hospital, Maltepe Mahallesi, Topkapı, Istanbul.
Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas 77030-4008.
Acad Radiol. 2019 Jun;26(6):e108-e114. doi: 10.1016/j.acra.2018.06.025. Epub 2018 Jul 31.
To evaluate computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) imaging manifestations of lymphomas secondarily involving the adrenal gland.
Seven patients (Five men, two women; median age [range], 66 years [34-75 years]) with pathologically proven adrenal lymphoma were assessed retrospectively. Clinical findings, prior history of lymphoproliferative malignancy, CT (n = 7) and fludeoxyglucose positron emission tomography-computed tomography (F-FDG-PET-CT) (n = 6) features were analyzed.
Six cases were diffuse large B-cell lymphoma, and one case was peripheral T-cell lymphoma. The longest diameter of the lesions ranged from 3.2 to 6.6 cm (median 4.3 cm). Six lesions were well-defined and one lesion was ill-defined. In five cases, an adreniform shape was preserved. No lesions contained fat, calcification or hemorrhage. Two lesions had necrosis on CT. Median (range) unenhanced CT density of six lesions was 31.8 (29.2-35.2) Hounsfield units. Following administration of IV contrast media (n = 6), three lesions enhanced homogenously whereas three enhanced heterogeneously. The median increase in attenuation was 35.1 Hounsfield units. Two patients had 15-minute delayed CT and they both demonstrated limited wash-out consistent with nonadenoma. Six patients had fludeoxyglucose positron emission tomography-computed tomography(F-FDG-PET-CT) and all lesions were fludeoxyglucose (FDG) avid with a median SUV of 18.6 (range: 10.3-49.2).
Secondary adrenal lymphomas usually manifest as, large (>3 cm), well-defined, homogenously or slightly heterogeneously enhancing masses on CT with preserved adreniform shape. These lesions tend to show limited wash-out and high fludeoxyglucose (FDG) uptake.
评估继发于肾上腺的淋巴瘤的计算机断层扫描（CT）和正电子发射断层扫描-计算机断层扫描（PET-CT）影像学表现。
回顾性评估了 7 名经病理证实的肾上腺淋巴瘤患者（5 名男性，2 名女性；中位年龄[范围]：66 岁[34-75 岁]）。分析了临床发现、淋巴增生性恶性肿瘤的既往史、CT（n=7）和氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描（F-FDG-PET-CT）（n=6）特征。
6 例为弥漫性大 B 细胞淋巴瘤，1 例为外周 T 细胞淋巴瘤。病变的最长直径范围为 3.2-6.6cm（中位数 4.3cm）。6 个病变边界清楚，1 个病变边界不清楚。在 5 例中，保留了肾上腺形状。无病变包含脂肪、钙化或出血。2 个病变 CT 上有坏死。6 个病变的 CT 平扫密度中位数（范围）为 31.8（29.2-35.2）Hu。静脉注射造影剂后（n=6），3 个病变均匀增强，3 个病变不均匀增强。平均（范围）增强后衰减增加 35.1Hu。2 例进行了 15 分钟延迟 CT，两者均表现为有限的洗脱，与非腺瘤一致。6 例进行了氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描（F-FDG-PET-CT），所有病变均摄取氟脱氧葡萄糖（FDG），SUV 中位数为 18.6（范围：10.3-49.2）。
继发性肾上腺淋巴瘤通常表现为 CT 上大于 3cm 的大、边界清楚、均匀或轻度不均匀强化肿块，保留肾上腺形状。这些病变倾向于表现为有限的洗脱和高氟脱氧葡萄糖（FDG）摄取。
