副腎原発悪性リンパ腫の1例

Abstract

65歳女.副腎に大きな腫瘤を形成した為に副腎腫瘍と診断され, 摘出組織の病理組織学的検索から副腎原発悪性リンパ腫と診断された症例を経験した.更に術後に出血傾向がみられた為, 骨髄生検を行い, 骨髄浸潤が証明された

A 65-year-old woman visited our hospital complaining of general fatigue and nausea. CT scan revealed a homogeneous mass in the left adrenal gland, which was seven centimeters in diameter. Mild swelling of the right adrenal gland was also suspected. We failed to find the primary tumor, although a metastatic non-functioning adrenal tumor was suspected. Adrenalectomy was performed under the diagnosis of a non-functioning adrenal tumor. Pathological examination showed a non-Hodgkin's lymphoma. Since a bleeding tendency gradually developed following the operation, a bone marrow biopsy was done, revealing an invasion by tumor cells. Patients with a malignant lymphoma involving the bone marrow should not be operated on because fatal complications may develop postoperatively. A malignant lymphoma should be considered as a possible diagnosis of adrenal tumors, although it is very rare.