Primair adrenaal lymfoom

Abstract

Primary adrenal lymphoma A primary adrenal lymphoma (PAL) is a very rare extranodal lymphoma with only about 400 cases described worldwide. PAL is a rapidly progressive disease. Since the advent of rituximab, there is an improvement in the prognosis, making it comparable to a classical diffuse large B-cell lymphoma (DLBCL). This article describes the medical history of a 62-year-old woman with a bilateral adrenal incidentaloma on a CT scan. She complained of vague symptoms such as nausea, vertigo and excessive sweating with minor weight loss. Additional testing revealed primary adrenal insufficiency, for which hydrocortisone and fludrocortisone substitution was started, significantly improving the patient’s symptoms. A right adrenalectomy demonstrated the presence of a DLBCL and staging with an FDG-PET-CT scan showed no additional lesions. As the adrenals were the only location of the disease, the diagnosis of PAL could be made.