PMC4531612_01
Axial CT scan showed a well-defined 10x10x10 cm-sized mass with homogeneous attenuation in the right suprarenal area.
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Abdominal CT scan showed a 10x10x10 cm-sized mass in the right suprarenal area which may have originated from the right adrenal gland (Figure 1).
Diffuse infiltration of atypical large lymphocytes having oval to round or irregular cleaved vesicular nuclei, conspicuous one or several nucleoli and frequent mitotic figures (Hematoxylin & eosin stain, x400).
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The cytoplasm was clear or amphophilic and moderate in amount (Figure 2).
Immunohistochemical staining shows diffuse positivity for B-cell marker, CD20 (x200).
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Neoplastic lymphocytes were positive for B-cell markers (L20, and MB-2) and negative for T-cell markers (L45RO, and L43) (Figure 3).
Axial CT scan showed a 3x2.5 cm-sized, ill defined, low-attenuated mass in the right suprarenal area.
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Follow-up CT scan showed a 3x2.5 cm sized ill defined, low attenuated mass in the right suprarenal area, suggesting a remaining mass (Figure 4).
Follow-up CT scan showed focal thickening of right diaphragmatic crus at the level of the upper margin of the right kidney.
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The patient received external irradiation with a total tumor dose of 4,000 rad over 4 weeks to the tumor-bearing area andfollow-up CT scan demonstrated focal thickening of the right diaphragmatic crus area at the level of the upper margin of the right kidney (Figure 5).