A case of intravascular large B-cell lymphoma in the left adrenal and another tumor in the right adrenal detected by (18)F-FDG PET/CT.

Objective: Intravascular large B-cell lymphoma (IVLBCL) is a rare but fatal malignancy with a rapid onset, and presenting as an aggressive variant of diffuse large B-cell non-Hodgkin's lymphoma. Fluoro-18-fluorine positron emission tomography/computed tomography ((18)F-FDG PET/CT) is reported to be highly sensitive in diagnosing lymphoma. Herein, we present our (18)F-FDG PET/CT findings at an early case of IVLBCL in bilateral adrenals. The patient had no symptoms. Positron emission tomography and CT images showed irregular density on bilateral adrenals indicating malignant tumor and also another tumor on the hepatic flexure of the colon. Both adrenal tumors had a maximum standardized uptake value (SUVmax) of 11.4, whereas the colon tumor had less SUVmax value. Histopathological examination further confirmed that the bilateral adrenal was IVLBCL, whereas the colon mass was a benign tumor.

Conclusions: We describe this case, to highlight the importance of (18)F-FDG-PET/CT in early diagnosis of IVLBCL in bilateral adrenals confirmed by pathology and in differentiating a highly malignant from a benign tumor.