Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Oct;14(5):1350-1357.
doi: 10.1007/s12328-021-01482-8. Epub 2021 Jul 20.

Synchronous gastric cancer and primary lymphoma of right adrenal gland: a case report

Shuichi Fukuda  1 , Tomoko Wakasa  2 , Hitoshi Hanamoto  3 , Taichi Koyama  4 , Yoshio Ohta  2 , Masatoshi Inoue  4 , Daisuke Terashita  4 , Atsushi Gakuhara  4 , Hideo Tomihara  4 , Katsuya Ohta  4 , Kotaro Kitani  4 , Kazuhiko Hashimoto  4 , Hajime Ishikawa  4 , Jin-Ichi Hida  4 , Yutaka Kimura  4
Affiliations
Case Reports

Synchronous gastric cancer and primary lymphoma of right adrenal gland: a case report

Shuichi Fukuda et al. Clin J Gastroenterol. 2021 Oct.

Abstract

This report presents an extremely rare case of synchronous gastric cancer and primary adrenal diffuse large B-cell lymphoma (DLBCL). An 82-year-old man underwent computed tomography, which revealed a heterogeneous appearing and hypodense adrenal mass and a gastric mass with no enlarged lymph nodes in the neck, mediastinum, abdomen, and inguinal region. Upper gastrointestinal endoscopy revealed a protruding gastric tumor. The specimens obtained from endoscopic biopsy were histologically confirmed to be adenocarcinoma. The hormonal findings eliminated functional adrenal tumor. The patient underwent distal gastrectomy with regional lymph node resection for gastric cancer and incisional biopsy of the adrenal mass. Based on the pathological findings, diagnoses of mixed mucinous and tubular adenocarcinomas of the stomach and adrenal DLBCL were confirmed. Postoperation, the patient received rituximab combined with low-dose doxorubicin, cyclophosphamide, vincristine, and prednisone (R-miniCHOP). Six courses of R-miniCHOP were planned, but were completed in only one course at the patient's request. The patient died 2 months after surgery.

Keywords: Adrenal lymphoma; Diffuse large B-cell lymphoma; Gastric cancer; Malignant lymphoma.

PubMed Disclaimer

Conflict of interest statement

Shuichi Fukuda, Tomoko Wakasa, Hitoshi Hanamoto, Taichi Koyama, Yoshio Ohta, Masatoshi Inoue, Daisuke Terashita, Atsushi Gakuhara, Hideo Tomihara, Katsuya Ohta, Kotaro Kitani, Kazuhiko Hashimoto, Hajime Ishikawa, Jin-ichi Hida and Yutaka Kimura declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
a, b Noncontrast-enhanced CT revealed a heterogeneous appearing and hypodense adrenal mass with irregular margins and shape (a, arrow), 70 mm in size, and a gastric mass (b, arrow), 30 mm in size, with no enlarged lymph nodes. c Contrast-enhanced CT revealed a slightly enhanced adrenal mass
Fig. 2
Fig. 2
Upper gastrointestinal endoscopy revealed a protruding gastric tumor in the gastric antrum of the posterior wall
Fig. 3
Fig. 3
a Hematoxylin and eosin staining of the adrenal mass showed a diffuse proliferation of large and atypical lymphocytes accompanied with small lymphocytes. b–e Immunohistochemical staining revealed that large and atypical lymphocytes were positive for CD20 (b) and negative for CD3 (c), cytokeratin AE1/AE3 (d), and desmin (e). The small CD3 + non-lymphoma T cells form the cellular infiltrate around the large and atypical lymphoma B cells (c)
Fig. 4
Fig. 4
a The size of the resected gastric specimen was 50 × 50 mm. b Hematoxylin and eosin staining of the gastric mass showed mixed mucinous and tubular adenocarcinomas
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Li S, Wang Z, Wu Z, et al. Clinical characteristics and outcomes of primary adrenal diffuse large B cell lymphoma in a large contemporary cohort: a SEER-based analysis. Ann Hematol. 2019;98:2111–2119. doi: 10.1007/s00277-019-03740-9. - DOI - PubMed
    1. Yang Y, Xie W, Ren Y, et al. A case report of primary adrenal lymphoma: a rare but aggressive and invasive disease. Medicine (Baltimore) 2020;99:e20938. doi: 10.1097/MD.0000000000020938. - DOI - PMC - PubMed
    1. Sehn LH, Salles G. Diffuse large B-cell lymphoma. N Engl J Med. 2021;384:842–858. doi: 10.1056/NEJMra2027612. - DOI - PMC - PubMed
    1. Møller MB, Pedersen NT, Christensen BE. Diffuse large B-cell lymphoma: clinical implications of extranodal versus nodal presentation—a population-based study of 1575 cases. Br J Haematol. 2004;124:151–159. doi: 10.1046/j.1365-2141.2003.04749.x. - DOI - PubMed
    1. Zhou Z, Sehn LH, Rademaker AW, et al. An enhanced International Prognostic Index (NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era. Blood. 2014;123:837–842. doi: 10.1182/blood-2013-09-524108. - DOI - PMC - PubMed

Publication types

MeSH terms