Mainly adrenal gland involving NK/T-cell nasal type lymphoma diagnosed with delay due to mimicking adrenal hemorrhage.
A 29-yr-old man, presented with abdominal pain and fever, had an initial computed tomography (CT) scan revealing low attenuation of both adrenal glands. The initial concern was for tuberculous adrenalitis or autoimmune adrenalitis combined with adrenal hemorrhage. The patient started empirical anti-tuberculous medication, but there was no improvement. Enlargement of cervical lymph nodes were developed after that and excisional biopsy of cervical lymph nodes was performed. Pathological finding of excised lymph nodes was compatible to NK/T-cell lymphoma. The patient died due to the progression of the disease even after undergoing therapeutic trials including chemotherapy. Lymphoma mainly involving adrenal gland in the early stage of the disease is rare and the vast majority of cases that have been reported were of B-cell origin. From this case it is suggested that extra-nodal NK/T-cell lymphoma should be considered as a cause of bilateral adrenal masses although it is rare.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Seon Mee
SM
Kang
Woong Ji
WJ
Kim
Kyung Ae
KA
Lee
Hong Sun
HS
Baek
Tae Sun
TS
Park
Heung Yong
HY
Jin
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000473:pathology; D000311:Adrenal Glands / Q000098:blood supply*; D000328:Adult; D003937:Diagnosis, Differential; D006470:Hemorrhage / Q000175:diagnosis; D006801:Humans; D007694:Killer Cells, Natural; D008198:Lymph Nodes / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D013601:T-Lymphocytes; D014383:Tuberculosis, Endocrine / Q000175:diagnosis