Fan Zhi-Nan, Shi Hong-Jin, Xiong Bo-Bo, Zhang Jin-Song, Wang Hai-Feng, Wang Jian-Song
Department of Urology, The Second Affiliated Hospital, Kunming Medical University, Kunming 650000, Yunnan Province, China.
World J Clin Cases. 2022 Jan 14;10(2):709-716. doi: 10.12998/wjcc.v10.i2.709.
Diffuse large B-cell lymphoma, which accounts for about approximately 30% to 40% of non-Hodgkin's lymphomas, is the most common type and is a class of aggressive B-cell lymphomas. However, diffuse large B-cell lymphomas primary to the adrenal gland are rare.
A 73-year-old man was admitted with abdominal pain and fatigue. After admission, enhanced adrenal computed tomography indicated irregular masses on both adrenal glands, with the larger one on the left side, approximately 8.0 cm × 4.3 cm in size. The boundary was irregular, and surrounding tissues were compressed. No obvious enhancement was observed in the arterial phase. Resection of the left adrenal gland was performed. Pathological diagnosis revealed diffuse large B-cell lymphoma. After surgery, the patient received R-CHOP immunochemotherapy. During the fourth immunochemotherapy, patient condition deteriorated, and he eventually died of respiratory failure.
R-CHOP is the conventional immunochemotherapy for primary adrenal diffuse large B-cell lymphoma. Surgery is mainly used to diagnose the disease. Hence, the ideal treatment plan remains to be confirmed.
弥漫性大B细胞淋巴瘤约占非霍奇金淋巴瘤的30%至40%，是最常见的类型，属于侵袭性B细胞淋巴瘤。然而，原发于肾上腺的弥漫性大B细胞淋巴瘤较为罕见。
一名73岁男性因腹痛和乏力入院。入院后，肾上腺增强计算机断层扫描显示双侧肾上腺有不规则肿块，左侧较大，大小约为8.0 cm×4.3 cm。边界不规则，周围组织受压。动脉期未见明显强化。行左肾上腺切除术。病理诊断为弥漫性大B细胞淋巴瘤。术后患者接受R-CHOP免疫化疗。在第四次免疫化疗期间，患者病情恶化，最终死于呼吸衰竭。
R-CHOP是原发性肾上腺弥漫性大B细胞淋巴瘤的传统免疫化疗方案。手术主要用于疾病诊断。因此，理想的治疗方案仍有待确定。
