Table_1_Clinical Features of 50 Patients With Primary Adrenal Lymphoma.DOCX

Background and Objective: Primary adrenal lymphoma is a rare, progressive, easily misdiagnosed adrenal tumor with a poor prognosis. There are limited data on its clinical characteristics, and these have been derived from small sample studies. This study aimed to identify the clinical characteristics and prognosis of primary adrenal lymphoma.Methods: This single-center study retrospectively analyzed data of 50 primary adrenal lymphoma patients treated between January 2008 and January 2018. Demographic information, biochemical indexes, computed tomography images, pathological findings, treatment regimens, and prognostic factors were analyzed.Results: The median age of onset was 60.3 years, and 30 (60.0%) of 50 patients were male. Abdominal pain was the most common symptom, followed by incidentaloma and B symptoms. On average, patients presented with elevated lactate dehydrogenase (348 IU/L, normal range 110–220 IU/L) and hydroxybutyrate dehydrogenase levels (287 IU/L, normal range 72–182 IU/L) and decreased high-density lipoprotein cholesterol levels (0.88 mmol/L, normal range > 0.9 mmol/L). Bilateral lesions in the adrenal glands were observed in 30 (60.0%) patients. Computed tomography showed that 42 (84%) patients had signs of infiltration. Diffuse large B-cell lymphoma was present in 44 (88%) patients. Immunohistochemistry revealed that 70.6% (12/17), 89.5% (17/19), 92.0% (23/25), and 68.8% (11/16) of patients were positive for MYC, p53, BCL2, and both MYC and BCL2, respectively. Combined chemotherapy was associated with a good prognosis.Conclusions: Early diagnosis of primary adrenal lymphoma depends on a combination of biochemical examination, imaging studies, and pathological biopsy, and combined chemotherapy may lead to a better prognosis.

背景与目标：原发性肾上腺淋巴瘤是一种罕见、进展迅速、易被误诊的肾上腺肿瘤，预后不良。关于其临床特征的资料有限，且这些资料主要来源于样本量较小的研究。本研究旨在识别原发性肾上腺淋巴瘤的临床特征及预后。方法：本研究为单中心回顾性分析，对2008年1月至2018年1月期间治疗的50例原发性肾上腺淋巴瘤患者的数据进行研究。分析了人口统计学信息、生化指标、计算机断层扫描图像、病理发现、治疗方案和预后因素。结果：发病中位年龄为60.3岁，50例患者中男性30例（占60.0%）。腹部疼痛是最常见的症状，其次是偶然发现的肿瘤和全身性症状。平均而言，患者的乳酸脱氢酶（LDH）水平升高（348 IU/L，正常范围为110–220 IU/L），羟基丁酸脱氢酶水平（287 IU/L，正常范围为72–182 IU/L）和低密度脂蛋白胆固醇水平降低（0.88 mmol/L，正常范围>0.9 mmol/L）。30例患者（占60.0%）存在肾上腺双侧病变。计算机断层扫描显示42例患者（占84%）有浸润迹象。44例患者（占88%）存在弥漫性大B细胞淋巴瘤。免疫组化结果显示，70.6%（12/17）的患者对MYC蛋白呈阳性，89.5%（17/19）的患者对p53蛋白呈阳性，92.0%（23/25）的患者对BCL2蛋白呈阳性，68.8%（11/16）的患者同时对MYC和BCL2蛋白呈阳性。联合化疗与良好的预后相关。结论：原发性肾上腺淋巴瘤的早期诊断依赖于生化检查、影像学研究和病理活检的结合，联合化疗可能有助于改善预后。