Pathmanathan Kylan, Kodali Venkata, Mohamad Abdulrazak
Department of General Medicine, Fiona Stanley Hospital, Perth, WA, Australia.
Department of Endocrinology, Saint John of God Hospital, Bunbury, WA, Australia.
Oxf Med Case Reports. 2020 May 23;2020(4):omaa030. doi: 10.1093/omcr/omaa030. eCollection 2020 Apr.
Approximately 250 cases of primary adrenal lymphoma have been reported. We describe an unusual presentation of this condition. Our patient is a 65-year-old male whom presented to the emergency department with 4 days of severe persistent hiccups. He had lost 26 kg in weight in the preceding 4 months. Computed tomography abdomen revealed large invasive bilateral adrenal masses. Biochemical evaluation confirmed adrenal insufficiency. Hiccups resolved within 24 h of steroid replacement. Adrenal biopsy confirmed a diffuse large B-cell lymphoma. Hypotheses for the aetiology of his hiccups include diaphragmatic irritation and primary adrenal insufficiency. This case is interesting for its rarity involving bilateral adrenal glands, Addison's disease from the primary adrenal tumour and rapid resolution of hiccups with corticosteroid therapy.
据报道，原发性肾上腺淋巴瘤约有250例。我们描述了这种疾病的一种不寻常表现。我们的患者是一名65岁男性，因持续4天的严重持续性呃逆就诊于急诊科。在之前的4个月里，他体重减轻了26公斤。腹部计算机断层扫描显示双侧肾上腺有巨大浸润性肿块。生化评估证实存在肾上腺功能不全。呃逆在类固醇替代治疗后24小时内缓解。肾上腺活检证实为弥漫性大B细胞淋巴瘤。其呃逆病因的假说包括膈肌刺激和原发性肾上腺功能不全。该病例因其罕见地累及双侧肾上腺、原发性肾上腺肿瘤导致艾迪生病以及皮质类固醇治疗后呃逆迅速缓解而令人感兴趣。
