title: Adrenal involvement in non-Hodgkin's lymphoma: four cases and review of literature.
abstract: Primary adrenal non-Hodgkin's lymphoma is very rare. We have seen 2 such cases among 241 cases of non-Hodgkin's lymphoma (0.83%) over the past 4 years. We could detect 2 more cases who had adrenal involvement, in addition to other extra nodal disease sites. Review of English literature revealed 65 cases of primary adrenal non-Hodgkin's lymphoma, most being single case reports. Salient features included-median age of 68 years (mean age of 47.25 years in our series), bilateral adrenal involvement in 60%, and predominantly diffuse large cell histology with 'B' cell immunophenotype. Adrenal insufficiency was present in two-thirds of the patients at diagnosis. Chemotherapy with or without radiotherapy is the mainstay of treatment. About half the patients respond to treatment, with median survival of 4 months. The high index of suspicion for early diagnosis and prompt treatment may improve outcome.
authors.affiliation: Department of Medical Oncology, Institute Rotary Cancer Hospital (IRCH), All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
authors.forename: Devinder
authors.initials: D
authors.lastname: Singh
authors.forename: Lalit
authors.initials: L
authors.lastname: Kumar
authors.forename: Atul
authors.initials: A
authors.lastname: Sharma
authors.forename: M
authors.initials: M
authors.lastname: Vijayaraghavan
authors.forename: Sanjay
authors.initials: S
authors.lastname: Thulkar
authors.forename: N
authors.initials: N
authors.lastname: Tandon
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016879:Salvage Therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome