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Acta clinica Croatica, Vol. 64. No. 3, 2025.

Book review

https://doi.org/10.20471/acc.2025.64.03.25

Aggressive Primary Adrenal Lymphoma Presenting as Poorly Differentiated Carcinoma: A Case Report

Davor Galušić orcid id orcid.org/0000-0001-5485-8529 ; Department of Internal Medicine, Division of Hematology, Split University Hospital Center, Split, Croatia *
Lučana Vicelić Čutura ; Department of Internal Medicine, Division of Hematology, Split University Hospital Center, Split, Croatia
Antonija Miljak ; Department of Internal Medicine, Division of Hematology, Split University Hospital Center, Split, Croatia
Nenad Kunac ; Department of Pathology, Judicial Medicine, and Cytology, Division of Pathology, Split University Hospital Center, Split, Croatia
Viktor Blaslov ; Department of Internal Medicine, Division of Hematology, Split University Hospital Center, Split, Croatia
Marija Petrić ; Department of Internal Medicine, Division of Hematology, Split University Hospital Center, Split, Croatia
Marko Lucijanić ; Department of Hematology, Dubrava University Hospital, Zagreb, Croatia

* Corresponding author.

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Abstract

Primary adrenal non-Hodgkin lymphoma (PAL) is an extremely rare extranodal
lymphoma. Diffuse large B-cell lymphoma (DLBCL) is the most common PAL subtype with a high
rate of bilateral involvement. We describe a unique clinical course in a patient with PAL initially misdiagnosed
as poorly differentiated carcinoma. After four cycles of initial treatment with a protocol for disseminated
carcinoma of unknown primary site, evaluation showed progression of the disease. Another
biopsy of the adrenal gland was performed and showed aggressive non-Hodgkin lymphoma of DLBCL
phenotype. After 8 cycles of R-CHOP therapy, the patient achieved complete remission which was
confirmed by PET-CT scan, together with marked clinical improvement and withdrawal of signs of
adrenal insufficiency which he developed during R-CHOP therapy. In conclusion, a diagnosis of PAL
is frequently challenging due to its nonspecific clinical and radiological manifestations, and requires
invasive procedures for pathologic examination. Inadequate biopsy sample can lead to misdiagnosis and
exposure to inappropriate therapies since PAL is an extremely rare disease.

Keywords

Adrenal gland neoplasms; Adrenal insufficiency; Non-Hodgkin lymphoma

Hrčak ID:

342951

URI

https://hrcak.srce.hr/342951

Publication date:

30.9.2025.

Article data in other languages: croatian

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