Primary Adrenal Lymphoma Pos Epstein–Barr Virus Reactivation Due Under Methotrexate

Abstract: Primary adrenal lymphoproliferative disorder (LPD) is an extremely rare disease that is widely known to be associated with methotrexate (MTX) use in patients with rheumatoid arthritis (RA). A 70-year-old man was incidentally found to have a tumor at the dorsal part of the liver in a medical check-up. He had a history of RA treated with MTX. Abdominal ultrasonography demonstrated a low echoic mass (30mm in diameter) at the dorsal part of the liver, located close to the inferior vena cava. Preoperative differential diagnoses included intrahepatic cholangiocarcinoma, adrenal tumor, and hepatic malignant lymphoma, but no definitive diagnosis was reached. On explorator adrenal gl right adre performed infiltration positive im Final diag classified Hodgkin-l In thi healing o the impor necrotic ti related EB nal glan