Key Clinical Message
A 75‐year‐old man with a left adrenal mass found on CT scan showed Hodgkin disease on biopsy. Bone marrow biopsy was normal. This is the fourth case in the literature of primary adrenal Hodgkin lymphoma. Multiple chemotherapy lines were given, and the patient years later are alive and in progression of disease.
Keywords: adrenal gland, adrenal mass, Hodgkin lymphoma, malignancy
A 75‐year‐old male patient presented to the hospital for painless jaundice and fever. The patient reported generalized weakness and a 10 kg weight loss in 2 months. After a few days of hospitalization and ruling out all possible diseases of the hepatobiliary system, a computed tomography scan (CT scan) of the abdomen and pelvis showed a large left adrenal mass measuring 4.3 × 3 cm (Figures 1 and 2). These findings were suggestive of metastatic malignancy.
Figure 1.
Axial view of CT scan of the abdomen and pelvis showing a large lobulated hypodense lesion in the left adrenal gland
Figure 2.
Coronal view of CT scan of the abdomen and pelvis showing a large lobulated hypodense lesion in the left adrenal gland
A CT‐guided left adrenal mass biopsy confirmed the diagnosis of Hodgkin lymphoma disease with nodular sclerosis subtype. A bone marrow biopsy ruled out involvement of disease. Therefore, the patient was diagnosed as Stage 1E primary unilateral left adrenal Hodgkin lymphoma.
The patient initially received prednisone; cyclophosphamide; doxorubicin; and dacarbazine chemotherapy for four cycles with a good response and resolution of the jaundice and fever. Despite all the treatments received over more than 7 years, the patient kept having progression of disease; he is still alive and still receiving treatment.
To the best of our knowledge, this is the fourth case of primary adrenal Hodgkin lymphoma to be reported in the literature.1
It is a rare disease manifestation in the adrenal gland, which is difficult to diagnose and treat.2
CONFLICT OF INTEREST
No conflict of interest to declare.
AUTHORS CONTRIBUTION
TH (Primary author): involved in the idea of the manuscript, analyzed the data, and wrote the manuscript. YZ: analyzed the data and drafted the manuscript.
Haykal T, Zayed Y. Primary adrenal Hodgkin lymphoma. Clin Case Rep. 2019;7:568–569. 10.1002/ccr3.2009
REFERENCES
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