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Primary malignant lymphoma combined with clinically "silent" pheochromocytoma in the same adrenal gland.

Babinska A, Peksa R, Sworczak K - World J Surg Oncol (2015)

Bottom Line: Laboratory examinations revealed a slight increase of 24-h urine vanillylmandelic acid and 24-h urinary methanephrine excretion.Histological examination revealed two intermingled tumor cell proliferations-diffuse B cell lymphoma and pheochromocytoma.Unexpected coexistence of catecholamine-producing tumor with the other adrenal lesion can lead to serious complications of diagnosis and treatment.The adequate preparation for surgery can protect patient from threatening catecholamine crisis.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology and Internal Medicine, Medical University of Gdansk, ul. Dębinki 7, 80-288, Gdańsk, Poland. a.mail@wp.pl.

ABSTRACT
An increased number of adrenal tumors are now diagnosed due to the increased number of abdominal CT scans being performed. We present the first case of malignant lymphoma combined with clinically "silent" pheochromocytoma in the same adrenal gland. An abdominal CT scan demonstrates unilateral adrenal lesion which suggests pheochromocytoma or adrenal carcinoma. Laboratory examinations revealed a slight increase of 24-h urine vanillylmandelic acid and 24-h urinary methanephrine excretion. Histological examination revealed two intermingled tumor cell proliferations-diffuse B cell lymphoma and pheochromocytoma.Unexpected coexistence of catecholamine-producing tumor with the other adrenal lesion can lead to serious complications of diagnosis and treatment. The adequate preparation for surgery can protect patient from threatening catecholamine crisis.

No MeSH data available.


Related in: MedlinePlus

In the immunohistological study, tumor cells were positive for leukocyte antigen CD20(+) (b, magnification ×10) and CD45(+) (c, magnification ×2), and focus of pheochromocytoma was positive for chromogranin A(+) (a, magnification ×2) and S-100 (d, magnification ×20)
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Fig2: In the immunohistological study, tumor cells were positive for leukocyte antigen CD20(+) (b, magnification ×10) and CD45(+) (c, magnification ×2), and focus of pheochromocytoma was positive for chromogranin A(+) (a, magnification ×2) and S-100 (d, magnification ×20)

Mentions: Microscopically, samples from the adrenal tumor revealed diffuse large B cell lymphoma (DLBCL) with the following immunophenotype: CD20(+), CD45(+), CD3(−), Ki67-50 %, CD5(−), CD10(−), BCL6(−), MUM1(−), and cyclin D1(−) (Fig. 2). Lymphoma infiltration exceeded the adrenal capsule and infiltrated adipose tissue and renal parenchyma. The microscopic picture of brown focus was consistent with the diagnosis of pheochromocytoma (chromogranin A(+) and S-100(+); Fig. 2).Fig. 2


Primary malignant lymphoma combined with clinically "silent" pheochromocytoma in the same adrenal gland.

Babinska A, Peksa R, Sworczak K - World J Surg Oncol (2015)

In the immunohistological study, tumor cells were positive for leukocyte antigen CD20(+) (b, magnification ×10) and CD45(+) (c, magnification ×2), and focus of pheochromocytoma was positive for chromogranin A(+) (a, magnification ×2) and S-100 (d, magnification ×20)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4588683&req=5

Fig2: In the immunohistological study, tumor cells were positive for leukocyte antigen CD20(+) (b, magnification ×10) and CD45(+) (c, magnification ×2), and focus of pheochromocytoma was positive for chromogranin A(+) (a, magnification ×2) and S-100 (d, magnification ×20)
Mentions: Microscopically, samples from the adrenal tumor revealed diffuse large B cell lymphoma (DLBCL) with the following immunophenotype: CD20(+), CD45(+), CD3(−), Ki67-50 %, CD5(−), CD10(−), BCL6(−), MUM1(−), and cyclin D1(−) (Fig. 2). Lymphoma infiltration exceeded the adrenal capsule and infiltrated adipose tissue and renal parenchyma. The microscopic picture of brown focus was consistent with the diagnosis of pheochromocytoma (chromogranin A(+) and S-100(+); Fig. 2).Fig. 2

Bottom Line: Laboratory examinations revealed a slight increase of 24-h urine vanillylmandelic acid and 24-h urinary methanephrine excretion.Histological examination revealed two intermingled tumor cell proliferations-diffuse B cell lymphoma and pheochromocytoma.Unexpected coexistence of catecholamine-producing tumor with the other adrenal lesion can lead to serious complications of diagnosis and treatment.The adequate preparation for surgery can protect patient from threatening catecholamine crisis.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology and Internal Medicine, Medical University of Gdansk, ul. Dębinki 7, 80-288, Gdańsk, Poland. a.mail@wp.pl.

ABSTRACT
An increased number of adrenal tumors are now diagnosed due to the increased number of abdominal CT scans being performed. We present the first case of malignant lymphoma combined with clinically "silent" pheochromocytoma in the same adrenal gland. An abdominal CT scan demonstrates unilateral adrenal lesion which suggests pheochromocytoma or adrenal carcinoma. Laboratory examinations revealed a slight increase of 24-h urine vanillylmandelic acid and 24-h urinary methanephrine excretion. Histological examination revealed two intermingled tumor cell proliferations-diffuse B cell lymphoma and pheochromocytoma.Unexpected coexistence of catecholamine-producing tumor with the other adrenal lesion can lead to serious complications of diagnosis and treatment. The adequate preparation for surgery can protect patient from threatening catecholamine crisis.

No MeSH data available.


Related in: MedlinePlus