Linfoma suprarrenal primário bilateral originado de células B com remissão após tratamento quimioterápico: relato de caso e revisão da literatura

Abstract

Adrenal lymphomas are extremely rare, with few cases described in current literature, contributing to their diagnostic complexity and often leading to them being overlooked as potential differential diagnoses. They are characterized by a high incidence of bilateral involvement of the adrenal glands and can be diagnosed through endocrine assessment, imaging studies, and histopathological examination.

We present a case of a patient reporting multiple nonspecific primary symptoms, including asthenia, anorexia, weight loss, abdominal and lower back pain, and digestive disturbances. Physical examination revealed no signs of lymphadenopathy, splenomegaly, or hepatomegaly. Laboratory tests were performed for prognostic and diagnostic purposes, notably showing preserved adrenal function. Imaging examinations aided in identifying a nodular mass in the adrenal glands. Subsequently, an ultrasound-guided biopsy of the identified mass was conducted, followed by anatomopathological and immunohistochemical studies, resulting in a diagnostic report of a primary bilateral B-cell-originated high-grade lymphoma consistent with diffuse large B-cell lymphoma of non-germinal center pattern.

A year after diagnosis, the patient was well, asymptomatic, exhibited a positive response to treatment, had no apparent sequelae, and showed clinical remission. In conclusion, this case highlights that despite its rarity, primary adrenal gland lymphoma should be considered as a potential differential diagnosis in the context of adrenal masses and nonspecific symptoms in epidemiologically susceptible patients.