{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:46:08Z","timestamp":1774521968630,"version":"3.50.1"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"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. Oncol."],"abstract":"<jats:p>Primary adrenal lymphoma (PAL) is a rare extranodal malignant tumor that poses significant diagnostic challenges due to its nonspecific clinical and imaging features. We report a case of unilateral PAL in a 55-year-old female presenting with flank pain and a hypodense adrenal mass. The lesion was characterized using dual-layer spectral detector computed tomography (CT) with analyses including virtual monoenergetic imaging, iodine density mapping, effective atomic number (Z-eff) calculation, and spectral attenuation curve evaluation. The mass demonstrated low attenuation, reduced iodine concentration (0.38\u20130.69 mg\/mL), low Z-eff values (7.51\u20137.71), and a flat spectral curve pattern\u2014findings consistent with hypovascular lymphoid tissue. Subsequent 18F-FDG PET\/CT confirmed intense focal metabolic activity in the adrenal lesion (SUV_max 14.3). Biopsy confirmed the diagnosis of diffuse large B-cell lymphoma (DLBCL), non-germinal center B-cell (non-GCB) subtype. Spectral CT facilitated early non-invasive diagnosis, enhanced lesion conspicuity, and guided appropriate biopsy. This case highlights its diagnostic utility. The present case demonstrates the potential diagnostic value of multi-parameter spectral CT in differentiating PAL from other adrenal masses. These preliminary findings suggest the possible clinical utility of this technique; however, its role requires further validation through large-scale studies in the future.<\/jats:p>","DOI":"10.3389\/fonc.2026.1639755","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T09:41:18Z","timestamp":1774518078000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Diagnostic value of spectral CT in primary adrenal lymphoma"],"prefix":"10.3389","volume":"16","author":[{"given":"Xiang","family":"Zhuang","sequence":"first","affiliation":[{"name":"Department of Radiology, Baotou Cancer Hospital","place":["Baotou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi xi","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Radiology, Baotou Cancer Hospital","place":["Baotou, 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