lymphoma of the adrenal gland

Imaging
features of adrenal masses. Left adrenal lymphomatous lesion in a 70-year-old man with non-Hodgkin lymphoma. Coronal reformatted CT images before (a) and after contrast injection in portal phase (b) show a large left adrenal mass (arrow) with inhomogeneous enhancement. Axial CT image of the lower abdomen in portal phase (c; arrow) shows the gastrointestinal involvement by lymphoma as aneurysmal dilatation of some loops of the small bowel
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Adrenal lymphoma can refer to:

  • primary adrenal lymphoma: rare 
    • can be bilateral in around 70% of cases
  • secondary involvement of the adrenal glands with lymphoma: more common

Clinical presentation

The presentation can be variable and may include adrenal insufficiency, worsening general state, weight loss, and abdominal pain.

Radiographic features

CT/MRI

Maybe seen as bulky adrenal masses. Often difficult to use bilaterality to differentiate primary versus secondary since the former can be bilateral in a considerable portion of cases.

Usually of soft tissue attenuation (40-60 HU) with mild progressive enhancement after contrast medium administration .

Nuclear medicine
  • often FDG avid
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