Home | About us | Editorial board | Search | Ahead of print | Current issue | Archives | Submit article | Instructions | Subscribe | Contacts | Advertise | Login 
 
Search Article 
  
Advanced search 
  Users Online: 1457 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  

 
Table of Contents
LETTER TO THE EDITOR
Year : 2011  |  Volume : 15  |  Issue : 4  |  Page : 350-351

Origin of primary adrenal lymphoma and predisposing factors for primary adrenal insufficiency in primary adrenal lymphoma


Department of Medicine (Diabetes and Endocrinology division), Indira Gandhi Government General Hospital, Puducherry, India

Date of Web Publication30-Sep-2011

Correspondence Address:
Sagili Vijaya Bhaskar Reddy
Department of Medicine (Diabetes and Endocrinology division), Indira Gandhi Government General Hospital, Puducherry - 605 001
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.85604

Rights and Permissions

How to cite this article:
Reddy SV, Prabhudesai S, Gnanasekaran B. Origin of primary adrenal lymphoma and predisposing factors for primary adrenal insufficiency in primary adrenal lymphoma. Indian J Endocr Metab 2011;15:350-1

How to cite this URL:
Reddy SV, Prabhudesai S, Gnanasekaran B. Origin of primary adrenal lymphoma and predisposing factors for primary adrenal insufficiency in primary adrenal lymphoma. Indian J Endocr Metab [serial online] 2011 [cited 2019 Dec 12];15:350-1. Available from: http://www.ijem.in/text.asp?2011/15/4/350/85604

Sir,

We read with interest the case report "Primary adrenal lymphoma: Differential involvement with varying adrenal function" recently published in your journal in the July-September issue. [1] The authors have presented a good and exhaustive literature review on the topic, but have not discussed the origin of lymphoma primarily from the adrenals.

We would like to highlight the fact that the occurrence of lymphoma primarily in the adrenal glands without involvement of any other lymphoid tissue in the body remains an enigma as the normal adrenal in humans is devoid of any lymphoid or hematopoietic tissue. [2] Proposed hypotheses for the occurrence of primary adrenal lymphoma include pre-existing autoimmune adrenalitis with lymphocyte infiltration or occurrence of hematopoietic rest tissue in the adrenals, although not conclusively proven due to the rarity of the disease. [2],[3] The follicular centre cell origin of primary adrenal lymphoma suggests that the tumor may have arisen on a background of previous autoimmune adrenalitis. [2] The occurrence of primary adrenal lymphoma in a setting of pre-existing autoimmune adrenalitis is analogous to the occurrence of primary lymphoma in the thyroid on a background of autoimmune Hashimoto's thyroiditis, as lymphatic tissue is absent in the normal thyroid tissue also.

The authors have discussed the occurrence of variable adrenal insufficiency in primary adrenal lymphoma on the basis of the extent of adrenal tissue involvement, with bilateral disease developing primary adrenal insufficiency and unilateral disease having normal adrenal function. [1] Adrenal insufficiency in patients with bilateral adrenal metastasis is rare (1%) [4] and develops only when >90% of the adrenal tissue is infiltrated. [5] In contrast, a very high frequency of primary adrenal insufficiency (60%-70%) has been reported in patients with primary adrenal lymphomas, including patients with mildly enlarged adrenals also. [2],[5] We would like to add that an additional mechanism that could explain the higher occurrence of primary adrenal insufficiency in patients with primary adrenal lymphoma as opposed to the rare occurrence in adrenal metastasis is the possibility of pre-existing autoimmune adrenalitis in patients with primary adrenal lymphoma. [2]

 
   References Top

1.Aziz SA, Laway BA, Rangreze I, Lone MI, Ahmad SN. Primary adrenal lymphoma: Differential involvement with varying adrenal function. Indian J Endocrinol Metab 2011;15:220-3.  Back to cited text no. 1
    
2.Ellis RD, Read D. Bilateral adrenal non-Hodgkin's lymphoma with adrenal insufficiency. Postgrad Med J 2000;76:508-9.  Back to cited text no. 2
    
3.Dutta P, Bhansali A, Venkatesan R, Mittal BR, Kumar V. Primary adrenal lymphoma. Endocrinologist 2005;15-340-2.  Back to cited text no. 3
    
4.Lam KY, Lo CY. Metastatic tumors of the adrenal glands: A 30-year experience in a teaching hospital. Clin Endocrinol (Oxf) 2002;56:95-101.  Back to cited text no. 4
    
5.Kandarakis ED, Chatzismalis P, Economou F, Lazarides S, Androulaki A, Kouraklis G. Primary adrenal lymphoma presented with adrenal insufficiency. Hormones 2004;3:68-73.  Back to cited text no. 5
    



This article has been cited by
1 Systemic and prophylactic intrathecal chemotherapy for primary adrenal lymphoma
Lei Yuan,Lu Sun,Jian Bo,Quanshun Wang,Yu Zhao
Medicine. 2019; 98(24): e15662
[Pubmed] | [DOI]
2 Primary Adrenal Lymphoma: A Single Center Experience
Rajeev Kasaliwal,Manjunath Goroshi,Kranti Khadilkar,Ganesh Bakshi,Venkatesh Rangarajan,Gaurav Malhotra,Anurag Lila,Tushar Bandgar,Nalini S Shah
Endocrine Practice. 2015; 1(-1): 1
[Pubmed] | [DOI]
3 Primary Bilateral Non-Hodgkin’s Lymphoma of the Adrenal Gland Presenting as Incidental Adrenal Masses
Christopher Rizzo,David James Camilleri,Alexandra Betts,Andre’ Gatt,Stephen Fava
Case Reports in Medicine. 2015; 2015: 1
[Pubmed] | [DOI]
4 Primary adrenal lymphoma: a systematic review
Armin Rashidi,Stephen I. Fisher
Annals of Hematology. 2013; 92(12): 1583
[Pubmed] | [DOI]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References

 Article Access Statistics
    Viewed1417    
    Printed38    
    Emailed0    
    PDF Downloaded365    
    Comments [Add]    
    Cited by others 4    

Recommend this journal