{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:12:28Z","timestamp":1793059948020,"version":"4.5.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Primary adrenal lymphoma (PAL) is a rare form of adrenal mass. We summarize our experience in its clinical presentation, biochemical indexes, radiological features, pathological information, therapy regimens, and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was an institutional review board-approved retrospective review of medical records and surgical pathology specimens of patients with a diagnosis of PAL at the Chinese People\u2019s Liberation Army General Hospital and the First Affiliate Hospital of Xiamen University between July 2007 and July 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-six patients were identified. The mean age at presentation was 60.84 \u00b1 13.14 years with a male-to-female ratio of 2.25:1 (18:8). The most common presenting symptoms were loss of appetite (65%, 17\/26), weight loss (62%, 16\/26), abdominal pain (58%, 15\/26), and fatigue (58%, 15\/26). The levels of lactate dehydrogenase (75%, 15\/20), \u03b2<jats:sub>2<\/jats:sub>-microglobulin (100%, 10\/10), C-reactive protein (82%, 14\/17), and ferritin (88%, 7\/8) and the erythrocyte sedimentation rate (83%, 10\/12) were elevated. Bilateral involvement was seen in 21 of 26 patients (81%); 12 of 19 evaluated patients with bilateral lesions (63%) were confirmed to have adrenal insufficiency. On computed tomography (CT), the mean tumor diameter was 7.31 \u00b1 3.35 cm and the median Hounsfield density was 37.0 HU (range: 31.0\u201345.0 HU); 67% (10\/15) and 27% (4\/15) of lesions presented with mild and moderate enhancement after injection of contrast medium. <jats:sup>18<\/jats:sup>F-fluorodeoxyglucose positron emission tomography (FDG PET)-CT revealed not only an adrenal tumor but also extra-adrenal lesions. Diffuse large B-cell lymphoma (DLBCL) was the most common phenotype (92%, 24\/26). Ninety-two percent (24\/26) of patients received chemotherapy while 8% (2\/26) received unilateral adrenalectomy plus chemotherapy. The prognosis of PAL was poor, with a general survival time of 7.20 \u00b1 5.18 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PAL is a rare disease. The clinical characteristics of PAL include loss of appetite and weight loss. Endocrine evaluation should be performed to determine whether patients have adrenal insufficiency, especially patients with bilateral lesions. FDG-PET appears to be more accurate than other imaging modalities in revealing extra-adrenal sites. Better therapy is required to improve the poor prognosis of PAL.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2021.778984","type":"journal-article","created":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T11:46:59Z","timestamp":1643370419000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Primary Adrenal Lymphoma: Two Case Series From China"],"prefix":"10.3389","volume":"12","author":[{"given":"Jinyang","family":"Zeng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangfang","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaohui","family":"Lyu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingtao","family":"Dou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiming","family":"Mu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingzhu","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoqing","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,1,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdg004","article-title":"Primary Extranodal Nonhodgkins Lymphoma(NHL): The Impact of Alternative Definitions Tested in the Comprehensive Cancer Centre West Population- Based NHL Registry","volume":"14","author":"Korl","year":"2003","journal-title":"Ann Oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-009-0870-z","article-title":"The Clinicopathological Analysis of 303 Cases With Malignant Lymphoma Classified According to the World Health Organization Classification System in a Single Institute of Taiwan","volume":"89","author":"Chen","year":"2010","journal-title":"Ann Hematol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23638","article-title":"Sites of Extranodal Involvement are Prognostic in Patients With Diffuse Large B-Cell Lymphoma in the Rituximab Era: An Analysis of the Surveillance, Epidemiology and End Results Database","volume":"89","author":"Castillo","year":"2014","journal-title":"Am J Hematol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197201)29:1<252::AID-CNCR2820290138>3.0.CO;2-#","article-title":"Occurrence and Prognosis of Extranodal Lymphomas","volume":"29","author":"Freeman","year":"1972","journal-title":"Cancer"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-013-1812-3","article-title":"Primary Adrenal Lymphoma: A Systematic Review","volume":"92","author":"Rashidi","year":"2013","journal-title":"Ann Hematol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcw174","article-title":"Adrenal Lymphoma: Presentation, Management and Prognosis","volume":"110","author":"Laurent","year":"2017","journal-title":"QJM"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-003-0838-3","article-title":"Primary Adrenal Lymphoma Presenting as Addison\u2019s Disease: Case Report and Review of the Literature","volume":"83","author":"Mantzios","year":"2004","journal-title":"Ann Hematol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e15662","DOI":"10.1097\/MD.0000000000015662","article-title":"Systemic and Prophylactic Intrathecal Chemotherapy for Primary Adrenal Lymphoma: A Retrospective Study of 20 Case Reports","volume":"98","author":"Yuan","year":"2019","journal-title":"Med (Baltimore)"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.4158\/EP14471.OR","article-title":"Primary Adrenal Lymphoma: A Single-Center Experience","volume":"21","author":"Kasaliwal","year":"2015","journal-title":"Endocr Pract"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1177\/030089160709300621","article-title":"Primary Bilateral Adrenal non-Hodgkin\u2019s Burkitt-Like Lymphoma: A Rare Cause of Primary Adrenal Insufficiency. 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