1Department of Hematology, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
2Department of Cytopathology, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
3Department of Nuclear Medicine, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
Primary adrenal lymphoma (PAL) is a rare and aggressive malignancy and involves bilateral adrenals in 60–75% of cases . The most common PALs are diffuse large B-cell lymphomas (-80%), followed by peripheral T cell lymphoma (7%) . Since the majority of intraocular lymphomas (IOL) are of B-cell origin, T-cell type IOLs are very rare and often secondary to cutaneous or adult T-cell lymphoma . Except for a single case report showing choroidal involvement, intraocular metastasis by PAL is extremely rare .
To the best to our knowledge, only 4 cases of T-cell type PAL have been reported in literature, but none of the cases had bone marrow involvement (Table 1) . The median age at diagnosis was 40 years (range, 31–70 yrs). The most common presentation is weight loss and most of the cases have poor outcome in spite of intensive chemotherapy.
In conclusion, we describe the first case of primary adrenal T-cell lymphoma with ocular and bone marrow metastasis in a young adult. In the absence of clinical evidence to suspect a primary adrenal pathology, our case reinforces the importance of thorough radiologic workup, especially 18F-FDG PET/CT, in the evaluation of occult lymphomas. In addition, we also emphasize the role of morphological evaluation combined with immunophenotyping for definite diagnosis in lymphomas.
Microscopic findings, immunohistochemical staining, and whole-body fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) of primary adrenal T-cell lymphoma.