Prikaz serije bolesnika s primarnim limfomom nadbubrežne žlijezde

master's thesis

• Title (english): Case series of patients with primary adrenal lymphoma
• Author: Petra Sabljak
• Mentor: Tina Dušek (mentor)
• Committee member: Darko Kaštelan (predsjednik povjerenstva)
• Committee member: Slavko Gašparov (član povjerenstva)
• Committee member: Tina Dušek (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Oncology

Abstract

Primarni limfom nadbubrežne žlijezde je izuzetno rijedak tumor. Bez obzira na njegovu rijetku pojavnost bitno ga je uvrstiti u diferencijalnu dijagnozu tumora nadbubrežne žlijezde. Ispravna i što ranija dijagnoza je ključna radi pravovremeno započetog kemoterapijskog liječenja. Dosad je u liječenju PAL-a najprimjenjivanija kemoterapijska shema R-CHOP. Neke od karakteristika PAL-a koje treba imati na umu pri diferencijalnog dijagnozi tumora nadbubrežne žlijezde su: starija životna dob bolesnika, prisutnost B simptoma, povišena razina LDH u serumu, bilateralna lokalizacija, adrenalna insuficijencija te negativni hormonskih testovi. Zbog svoje rijetke pojavnosti PAL često ne biva uvršten u diferencijalnu dijagnozu tumora nadbubrežne žlijezde te se liječenje započinje kirurškom resekcijom tumora, što je terapija izbora za češće prisutne malignome nadbubrežne žlijezde, adrenalni karcinom i feokromocitom. U ovom radu je opisano 5 slučajeva bolesnika s primarnim limfomom nadbubrežne žlijezde. Klinička prezentacija, karakteristike tumora, tijek liječenja, prognoza i preživljenje bolesnika iz slučajeva uspoređeni su sa slučajevima iz literature. Starost bolesnika pri dijagnozi je bila između 68 i 73 godine. Svi tumori su bili DLBCL podtipa. U jednom slučaju se radilo o bilateralno lokaliziranom tumoru uz prisutnu adrenalnu insuficijenciju, dok su je u 4 slučaja tumor bio unilateralne lokalizacije. Tri bolesnika su inicijalno liječena kirurškim zahvatom. Svim bolesnicima je tijekom liječenja ordinirana
kemoterapija po CHOP i CHOP-u sličnim protokolima, međutim, samo je jedan bolesnik primio svih 6 ciklusa. Samo u jednog bolesnika je postignuta kompletna remisija bolesti.

Abstract (english)

Primary adrenal lymphoma is an extremely rare tumor. Regardless of its rare incidence, it is important to include PAL as a differential diagnosis of adrenal gland tumor. Correct and early diagnosis is essential for timely chemotherapeutic treatment. Nowadays, the most commonly used treatment of PAL is R-CHOP chemotherapy regimen. Some characteristics of PAL that should be considered in differential diagnosis are: elderly patients, presence of B symptoms, elevated LDH in serum, bilateral localization, adrenal insufficiency and negative hormonal tests. Because of its rare incidence PAL is often omitted from differential diagnosis of adrenal gland tumors and the primary treatment is often surgical resection, therapy of choice for the most common adrenal gland malignancy, adrenal carcinoma and heochromocytoma. In this paper five cases of PAL were presented. Clinical presentation, tumor characteristics, course of treatment, survival and prognosis in these cases were compared with literature. Age of patients at diagnosis was between 69 and 73. All tumors were DLBCL subtype. One patient had bilaterally localized tumor with adrenal insufficiency, while in 4 other cases tumors were unilateral. Three patients were initially treated surgically. To all patients CHOP or CHOP-like
chemotherapy regimens were initiated, but only one patient received all 6 cycles. Complete remission was achieved in only one patient.

• Keywords: primarni limfom nadbubrežne žlijezde; DLBCL; adrenalna insuficijencija
• Keywords (english): primary adrenal lymphoma; adrenal insufficiency; DLBCL
• Language: croatian
• URN:NBN: urn:nbn:hr:105:723416
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-03-02 10:26:00