Intravascular B-large cell lymphoma: an unexpected diagnosis of an incidental adrenal mass

Journal of Surgical Case Reports
Andreas Kiriakopoulos, Dimitrios Linos

Abstract

Adrenal incidentalomas originally defined as tumors discovered serendipitously in the course of diagnostic evaluation or follow-up of unrelated disorders, may occasionally pose serious diagnostic challenges. Intravascular large B-cell lymphoma (IVLBCL) may be a rare example of such a case. We present an IVLBCL confined to the adrenal gland in a 52-year-old man focusing on its diagnostic and therapeutic aspects. On endocrine work up, the tumor was hormonally inactive and exhibited inconclusive imaging characteristics without signs of locoregional spread. After a left laparoscopic adrenalectomy, histologic sections revealed the presence of tumor cells inside dilated, thin-walled vascular spaces. Immunohistochemical stains confirmed the diagnosis of IVLBCL. The patient was then referred to a Hematology Unit for further staging and treatment and received six cycles of R-CHOP. Despite the fact that IVLBCL carries a dismal prognosis our patient remains alive and in complete remission 6 years after the initial diagnosis.

References

Aug 1, 1997·Histopathology·J H ShanksA J Freemont
May 10, 2007·Haematologica·Andrés J M FerreriUNKNOWN International Extranodal Lymphoma Study Group (IELSG)
Nov 11, 2008·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Sumathi SrivatsaSanjay Logani
Sep 1, 2009·The Lancet Oncology·Kazuyuki ShimadaShigeo Nakamura

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