Linfoma B intravascular: comprometimento bilateral da suprarrenal em paciente adulta jovem / Intravascular large B cell lymphoma: impairment of bilateral adrenal in young woman

O linfoma B intravascular de grandes células (IVLBCL) é uma doença rara caracterizada pela proliferação neoplásica de células linfoides no interior de capilares. Relatamos um caso de IVLBCL em paciente jovem do sexo feminino com comprometimento bilateral da glândula suprarrenal. O exame imuno-histoquímico confirmou o IVLBCL. A afinidade entre órgãos endócrinos e células linfoides é uma hipótese levantada para explicar a correlação verificada entre o IVLBCL e o comprometimento da glândula suprarrenal. Além disso, a associação entre o IVLBCL e a sintomatologia descrita parece refletir um padrão que poderá auxiliar em um diagnóstico mais eficaz.

The Intravascular Large B-cell Lymphoma (IVLBCL) is a rare disease characterized by neoplastic proliferation of lymphoid cells within capillaries. We report a case of IVLBCL in a young female patient with bilateral involvement of the adrenal gland. Immunohistochemical examination confirmed IVLBCL. The relationship between endocrine organs and lymphoid cells is a hypothesis to explain the correlation observed between IVLBCL and the involvement of the adrenal gland. Moreover, the association between IVLBCL and the described symptomatology seems to reflect a pattern that may assist in a more effective diagnosis.

Primary Central Nervous System Lymphoma Associated with Systemic Lymphoma: Case Report

Primary central nervous system(CNS) lymphoma is an uncommon neoplasm which is considered to be radiosensitive. We have recently experienced one of such cases with a history of systemic lymphoma(diffuse histiocytic lymphoma) of the left cheek and left forearm in a 56-year-old man. Chief complaints include headache and generalized weakness for 1 month. MRI(magnetic resonance imaging) revealed an enhancing irregular mass lesion in both the basal ganglia and corpus callosum with minimal surrounding brain edema. CSF analysis and cytology revealed no specific abnormal findings. Without brain biopsy, we concluded that the lesion was a primary CNS lymphoma based on the fact that the patient have had a history of diffuse histiocytic lymphoma and MRI findings were compatible to primary CNS lymphoma. He was treated with dexamethasone for 2 weeks and 3900 cGy radiation therapy for 5 weeks. He improved gradually, and control MRI after radiotherapy showed complete resolution of the lesion.