¹⁸F-FDG PET imaging in primary adrenal lymphoma

Objective: To evaluate ¹⁸F-FDG PET/CT imaging in primary adrenal lymphoma (PAL). Methods: Three male patients with clinically diagnosed PAL, aged 59 to 77 years old, were examined by ¹⁸F-FDG PET/CT before histopathologic examination. The SUV_max ratio of tumor to liver (T/L) was calculated on ¹⁸F-FDG PET images. All patients underwent R-CHOP (rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy regimens. One patient had serial follow-up ¹⁸F-FDG PET/CT post therapy. Results: The final diagnosis of all 3 cases was bilateral diffuse large B-cell lymphoma. The pathologic results of bone marrow biopsy were negative. Case 1 was in disease remission based on four times of follow-up ¹⁸F-FDG PET/CT. The patient's clinical follow-up was also negative and he was currently alive for more than 19 months. Case 2 was of late stage and suffered from adrenal insufficiency. He died 6 months after the diagnosis. Case 3 (the eldest patient) was treated with partial excision followed by the chemotherapy. He died of lung infection 12 months after treatment. Conclusion: ¹⁸F-FDG PET/CT may be of important value for maximizing patient management and survival for patients with PAL, a rare and highly malignant disease. (authors)