抄録
We report here an unusual autopsy case of bilateral adrenal lymphoma showing symptoms associated with hypercalcemia and taking a fulminant clinical course. The serum of the patient had a titer of 40pg/ml of intact parathyroid hormone (normal range: 10-65pg/ml) and a titer of 1720pmol/l of parathyroid hormone-related protein (PTHrP) (normal range: 13.8-55.3pmol/l). Autopsy revealed bilateral huge adrenal tumors, with the left weighing 230g, and measuring 12×9×3.5cm, and the right weighing 140g and measuring 11×8×3cm. Histological examination revealed that the adrenal tumors were diffuse large cell lymphoma, and that the neoplastic cells were positive for CD20 (L26) and CD79a (mb-1). In addition, the neoplastic cells were positive for PTHrP mostly in the perinuclear space of the cells. In addition to the coma associated with hypercalcemia and acute renal failure, congestion and bronchopneumonia developed, leading to the death of the patient. There have been three case reports of bilateral adrenal lymphoma associated with hypercalcemia. Hypercalcemia should be checked carefully in the cases with adrenal lymphoma because it may result in fulminant clinical course.
