CT and 18F-FDG PET/CT features of adrenal lymphoma
ZHU Yuanyi1,2,YIN Longlin1,3,TONG Lunbing2,WANG Jin2,MA Wanhui2,WU Ying2, and ZHANG Yi2
1.Department of Medical Imaging, Southwest Medical University ,Luzhou 646000, China; 2.Department of Radiology, Sichuan Provincial Corps Hospital, Chinese People’s Armed Police Force, Leshan 614000, China; 3.Department of Radiology, Sichuan Provincial People’s Hospital, Chengdu 610072, China
Abstract：Objective To explore the CT and 18F-FDG PET/CT features of adrenal lymphoma in order to learn more about this disease.Methods The clinical data on ten patients with adrenal lymphoma confirmed surgically and pathologically was retrospectively analyzed. All the patients received CT scan, and all of them were examined by 18F-FDG PET/CT. The general data on these patients, including age, gender, CT signs of the disease including the location, maximum diameter, shape, margin, density, the degree of enhancement and retroperitoneal lymph nodes, was analyzed and compared, while the rate of enhancement in each phase and the SUVmax value were calculated.Results There were seven cases of primary adrenal lymphoma and three cases of secondary adrenal lymphoma. There were a total of 17 lesions, including seven cases of bilateral lesions and three cases of unilateral lesions. The tumors were different in size, with an average size of 5.6 cm.Thirteen lesions were oval in shape, three triangular, and one irregular as nodular hyperplasia.Thirteen lesions had clear margins and the rest had ill-defined margins. The average value determined by CT plain scan was 40.4 Hu, the average rate of enhancement was 24.28% in the arterial phase, and 37.46% in the portal phase.Fourteen lesions were presented as homogeneous density on plain CT and homogeneous enhancement was observed in thirteen lesions. Lesions showed mild to moderate enhancement in the arterial phase, and the tumors showed gradual enhancement in the portal phase. Adrenal lesions showed intense FDG uptake on PET/CT with SUVmax ranging from 8.7 to 23.5, with a mean value of 12.5.Conclusions Primary and secondary adrenal lymphoma has some CT features. PET/CT can accurately demonstrate the extent of tumor involvement and lymph nodes, which can facilitate diagnosis and clinical management.
Rashidi A, Fisher S I. Primary adrenal lymphoma: a systematic review[J]. Ann Hematol,2013,92(12):1583-1593.
[2]
Zhou L, Peng W, Wang C, et al. Primary adrenal lymphoma: Radiological; Pathological, clinical correlation[J]. Euro J Radiology,2012,81(3):401-405.
[3]
Spyrogou A, Schneider H S, Mussack T,et al. Primary adrenal lymphoma:3 case reports with different outcomes[J]. Exp Clin Endocrinol Diabetes,2011,119(4):208.
[4]
Kim K M, Yoon D H, Lee S G, et al. A case of primary adrenal diffuse large B-cell lymphoma achieving complete remission with rituximab-CHOP chemotherapy[J]. J Korean Med Sci,2009,24(3):525-528.
Kumar R, Xiu Y, Mavi A, et al. FDG-PET imaging in primary bilateral adrenal lymphoma: a case report and review of the literature.[J]. Clin Nucl Med,2005,30(4):222-230.
[14]
Tsukahara T, Takasawa A, Murata M, et al. NK/T-cell lymphoma of bilateral adrenal glands in a patient with pyothorax[J]. Diagn Pathol,2012,7(1):114.
[15]
Sakthivel A, Kekre N S, Gopalakrishnan G. Unilateral asymptomatic adrenal tuberculoma: the role of percutaneous biopsy[J]. Scand J Urol Nephrol,2007,41(1):77-78.
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