A Case of Primary Adrenal Lymphoma with Invasion to the Right Kidney and the Liver

Takahisa Matsuoka, Norichika Matsui, Kazunori Oka, Kentaro Nishi and Tomoaki Morita

Department of Surgery, Syutoh General Hospital

A 78-year-old man admitted for right hypochondralgia and back pain was found in blood tests to have elevated LDH and in abdominal CT and MRI to have an enhanced right adrenal gland tumor 15×10 cm in diameter with direct invasion to the right kidney and liver suspected. Angiography showed tumor staining from the right inferior adrenal artery. The IVC was dislocated by the tumor and collateral vessels had developed. Under a diagnosis of malignant adrenal tumor, we resected the right hepatic lobe and the right kidney en bloc with the tumor. The resected specimen weighed 1.3 kg, and showed a whitish solid elastic hard mass with direct invasion to the right hepatic lobe and the right kidney. The tumor was diagnosed histopathologically as malignant lymphoma, diffuse mixed B-cell type. The patient was discharged on postoperative day 29 and underwent 4 courses of postoperative CHOP treatment. He remains alive and well without evidence of recurrence 2 years after surgery. We suggested that his case emphasizes the importance of rapid diagnosis and intensive therapy in primary adrenal lymphoma.

Key words
malignant lymphoma, adrenal gland, surgery

Reprint requests
Takahisa Matsuoka Department of Surgery, Nagato General Hospital
85 Higashifukawa, Nagato, 759-4194 JAPAN

Accepted
November 30, 2004

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