[A clinical analysis of 21 cases of adrenal non-Hodgkin's lymphoma].

Objective: To elaborate the clinical characteristics of adrenal non-Hodgkin's lymphoma and to expand the clinical thinking of adrenal tumors.
Methods: 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.
Results: 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.
Conclusions: 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.