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Rare disease
CASE REPORT
Mantle cell lymphoma presenting as bilateral adrenal huge masses
  1. Abtin Doroudinia1,
  2. Mehrdad Bakhshayesh Karam2,
  3. Mostafa Ranjbar1,
  4. Arash Nikmanesh3,
  5. Payam Mehrian4
  1. 1 Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2 Pediatric Respiratory Diseases Research Center (PRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3 Digestive Disease Research Center (DDRC), Digestive Disease Research Institute (DDRI), Tehran University of Medical Sciences, Tehran, Iran
  4. 4 Telemedicine Research Center (TRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), University of Medical Sciences, Tehran, Iran
  1. Correspondence to Dr Abtin Doroudinia, abtin1354{at}gmail.com

Summary

We present a middle-aged woman complaining of weakness, lethargy and weight loss for 6 months. Positron emission tomography (PET)/CT scan revealed huge bilateral adrenal masses with intense 18F-fluorodeoxyglucose avidity. Biopsy and immunohistochemical staining were compatible with mantle cell lymphoma (MCL). The patient received six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) followed by four cycles of intrathechal methotrexate chemotherapy. Bone marrow aspiration biopsy was performed for initial staging and also before bone marrow transplantation. Follow-up PET/CT scan after completion of chemotherapy and before bone marrow transplantation demonstrated complete metabolic response with no evidence of abnormal metabolic activity in either adrenal gland or bone marrow. MCL has an aggressive nature and is usually considered incurable; however, there have been a few reports indicating favourable treatment response when MCL is rarely arising from the adrenal glands. Dramatic response of a primary adrenal MCL to R-CHOP is documented in this case.

  • chemotherapy
  • radiology
  • oncology

https://doi.org/10.1136/bcr-2017-223247

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    Footnotes

    • Contributors AD (Corresponding author): case report concept and design, final manuscript approval. MBK: critical manuscript revision. MR: manuscript drafting, literature review. AN: pathology review. PM: Manuscript critical review

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.