Adrenal gland and paraganglia
Other adrenal malignancies

Author: Lan L. Gellert, M.D., Ph.D. (see Authors page)

Revised: 21 June 2016, last major update June 2016

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Lymphoma [title] adrenal
Cite this page: Lymphoma. website. Accessed April 26th, 2017.
Definition / General
    Primary adrenal lymphoma:
    • Rare, < 200 cases reported
    • Usually presents with bilateral adrenal masses, often with adrenal hypofunction
    • Subtype usually diffuse large B cell lymphoma
    Secondary adrenal involvement is common
    • Adrenal involvement in up to 25% with disseminated lymphoma at autopsy
    • Usually no associated adrenal insufficiency
Essential Features
  • Primary adrenal lymphoma is rare
    • Most cases have bilateral adrenal involvement and adrenal insufficiency
    • Diffuse large B cell lymphoma most common
Clinical Features
Radiology Images

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Bilateral, homogenous adrenal gland enlargement

Fluorodeoxyglucose PET

Prognostic Factors
  • Poor prognosis; most die within one year
  • Adrenal insufficiency and administration of chemotherapy are significant prognostic factors (Ann Hematol 2013;92:1583)
  • CNS involvement adversely affects long term prognosis (Ann Hematol 2013;92:1583)
Case Reports
  • Surgery and chemotherapy
  • CHOP / CHOP-like chemotherapy regimen plus rituximab
Micro Description
Micro Images

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Primary adrenal gland diffuse large B cell lymphoma is CD45+, CD20+

Primary adrenal gland Hodgkin lymphoma

Positive Stains
Negative Stains
Electron Microscopy Images

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Missing Image

Diffuse large B cell lymphoma

Molecular / Cytogenetics Description
Differential Diagnosis
  • Metastatic carcinoma: Cytokeratin+, negative for lymphoid markers
  • Metastatic melanoma: S100+, MelanA+, HMB45+
  • Primary adrenal tumor: negative for lymphoid markers