title: A patient with bilateral primary adrenal lymphoma, presenting with fever of unknown origin and achieving long-term disease-free survival after resection and chemotherapy.
abstract: Primary adrenal lymphoma is extremely rare. We describe a 64-year-old female patient who presented with fever of unknown origin. Imaging studies demonstrated bilateral bulky adrenal masses. She underwent bilateral adrenalectomy and the pathological diagnosis was large cell immunoblastic (B-cell) lymphoma. She received adjuvant combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone in the following 6 months. She has been relapse free for 52 months. To the best of our knowledge, this case has the longest disease-free survival among those reported. The present case indicated that primary adrenal lymphoma should be included in the differential diagnosis of fever of unknown origin and/or suprarenal mass. Chemotherapy following surgical resection may be considered the treatment of choice.
authors.affiliation: Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.
authors.forename: H C
authors.initials: HC
authors.lastname: Wu
authors.forename: L Y
authors.initials: LY
authors.lastname: Shih
authors.forename: T C
authors.initials: TC
authors.lastname: Chen
authors.forename: S H
authors.initials: SH
authors.lastname: Chu
authors.forename: C C
authors.initials: CC
authors.lastname: Tsai
mesh_terms: D000302:Adrenal Cortex / Q000473:pathology*; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005260:Female; D005335:Fever of Unknown Origin / Q000175:diagnosis*; D006801:Humans; D016400:Lymphoma, Large-Cell, Immunoblastic / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D008875:Middle Aged; D011379:Prognosis; D013997:Time Factors