ArticleFrontiers in oncology2026
Case Report: Diagnostic value of spectral CT in primary adrenal lymphoma.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Primary adrenal lymphoma (PAL) is a rare extranodal malignant tumor that poses significant diagnostic challenges due to its nonspecific clinical and imaging features. We report a case of unilateral PAL in a 55-year-old female presenting with flank pain and a hypodense adrenal mass. The lesion was characterized using dual-layer spectral detector computed tomography (CT) with analyses including virtual monoenergetic imaging, iodine density mapping, effective atomic number (Z-eff) calculation, and spectral attenuation curve evaluation. The mass demonstrated low attenuation, reduced iodine concentration (0.38-0.69 mg/mL), low Z-eff values (7.51-7.71), and a flat spectral curve pattern-findings consistent with hypovascular lymphoid tissue. Subsequent 18F-FDG PET/CT confirmed intense focal metabolic activity in the adrenal lesion (SUV_max 14.3). Biopsy confirmed the diagnosis of diffuse large B-cell lymphoma (DLBCL), non-germinal center B-cell (non-GCB) subtype. Spectral CT facilitated early non-invasive diagnosis, enhanced lesion conspicuity, and guided appropriate biopsy. This case highlights its diagnostic utility. The present case demonstrates the potential diagnostic value of multi-parameter spectral CT in differentiating PAL from other adrenal masses. These preliminary findings suggest the possible clinical utility of this technique; however, its role requires further validation through large-scale studies in the future.
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