PMC4746844_01
Biopsy of the left adrenal mass: (a and b) Photomicrographs showing features of nonHodgkin's lymphoma with diffuse architecture composed of intermediate to large atypical lymphoid cells (H and E, x4 and x40 respectively). (c) Immunohistochemistry is positive for leukocyte common antigen (x40). (d) CD-3 (x40). (e) CD-56 (x40). Immunohistochemistry was negative for (f) CD-20 (x40). (g) CD-4 (x40). (h) CD-8 (x40)
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F1
CT guided biopsy with immunohistochemistry revealed tumor cells positive for leukocyte common antigen, CD3, and weakly positive for CD56; while negative for CD20, CD4, and CD8 suggestive of high-grade NHL of T/NK cell immunophenotype [Figure 1].
Increased fluorodeoxyglucose uptake was noted in the left suprarenal gland on maximum intensity projected: (a). Axial positron emission tomography/computed tomography. (b) Coronal positron emission tomography/computed tomography. (c) Images of the staging positron emission tomography/computed tomography scan in case of biopsy proven adrenal lymphoma. Positron emission tomography/computed tomography scan done post four cycles of "SMILE" chemotherapy regimen revealed complete metabolic and morphological response (d-f)
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F2
No focus of hypermetabolism was noted elsewhere in the body suggestive of Stage I Aex (left adrenal) [Figure 2].