Correlations between MDCT features and clinicopathological findings of primary adrenal lymphoma

Publication date: Available online 2 February 2019

Source: European Journal of Radiology

Author(s): Ling yang, Mengni Zhang, Shuang Zhao, Yajun Hu, Jin Yao

ABSTRACT

Objective

To investigate the MDCT features of primary adrenal lymphoma (PAL) and correlate the results with clinicopathological findings.

Materials and Methods

Twenty eight patients (17 men, 11 women; median age, 61.5years) with pathologically confirmed PAL were included in this study. MDCT features of the lesions were retrospectively reviewed and correlated with clinicopathological findings.

Results

All of the 28 cases were non-Hodgkin's lymphoma (NHL), in which 25 cases were diffuse large B-cell lymphoma and 3 cases T-cell lymphoma. 21 (75%) patients had bilateral tumors with maximum diameter of 3.9-17.7 cm (median, 9.18 cm), and 7 (25%) patients had unilateral tumors with maximum diameter of 4.3-14.9 cm (median, 8.6 cm). The sign of infiltrating adjacent organs and encasing adjacent vessels were appeared in 10 and 15 patients respectively, in which 9 patients had both signs. 20 (71.4%) patients had the appearance of adeniform, and 3 (10.7%) patients showed infiltrating and embedding the adrenal gland. Among all the patients, 27 (96.4%) and 26 (92.9%) patients had mild enhancement on arterial and parenchymal phase, respectively; and 12 (42.8%) were homogenous, 14 (50%) slightly inhomogeneous and 2 (7.1%) heterogeneous on both phase. In addition, adrenal insufficiency was found in 33.3% (7/21) of the patients with bilateral lesions, and none in unilateral lesions.

Conclusion

Large adrenal soft tissue mass with maintenance of adreniform shape, encasing vessels, homogenous or slightly inhomogeneous density with no calcification, and mild enhancement on both arterial and parenchymal phase could be seen as the main MDCT features of PAL. In addition, infiltrating and embedding the adrenal gland may be specific imaging characteristics of PAL.

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