30 January 2024
: Case report 
Uncovering Primary Extranodal Diffuse Large B Cell Lymphoma in the Adrenal and Thyroid Glands
Unusual clinical course, Challenging differential diagnosis, Rare disease
Judy Li
1ABDEF*, Raisa Balbuena-Merle2BDE, Morgan Hrones3BDE, Courtney Elizabeth Gibson1ADEF
DOI: 10.12659/AJCR.942659
Am J Case Rep 2024; 25:e942659
Table 1. Case 1 laboratory findings upon presentation (initial workup).
| Value (reference range) | |
|---|---|
| White blood cell count | 5.4 (4.0–11.0×1000/µL) |
| Red blood cell count | 4.55 (4–6 M/µL) |
| Hemoglobin | 14.1 (11.7–15.5 g/dL) |
| Hematocrit | 42.60 (35.00–45.00%) |
| Mean corpuscular volume | 93.6 (80.0–100.0 fL) |
| Mean corpuscular hemoglobin | 31.0 (27.0–33.0 pg) |
| Mean corpuscular hemoglobin concentration | 33.1 (31.0–36.0 g/dL) |
| Red cell distribution width | 13.2 (11.0–15.0%) |
| Platelets | 267 (150–420×1000/µL) |
| Mean platelet volume | 11.4 (8.0–12.0 fL) |
| Neutrophils | 40.5 (39.0–71.0%) |
| Lymphocytes | 41.4 (17.0–50.0%) |
| Monocytes | 11.6 (4.0–12.0%) |
| Eosinophils | 5.8 (0.0–5.0%) |
| Basophils | 0.7 (0.0–1.4%) |
| Immature granulocytes | 0.0 (0.0–1.0%) |
| Nucleated red blood cells | 0.0 (0.0–1.0%) |
| Sodium | 140 (136–144 mmol/L) |
| Potassium | 4.2 (3.3–5.3 mmol/L) |
| Chloride | 102 (98–107 mmol/L) |
| Blood urea nitrogen | 12 (8–23 mg/dL) |
| Creatinine | 0.57 (0.40–1.30 mg/dL) |
| Alanine aminotransferase | 107 (10–35 U/L) |
| Alanine aminotransferase | 91 (10–35 U/L) |
| Alkaline phosphatase | 77 (9–122 U/L) |
| Total bilirubin | 0.4 (≤1.2 mg/dL) |
| Thyroid stimulating hormone | 3.7 (0.27–4.20 µIU/mL) |
| Free cortisol, overnight dexamethasone suppression test | 1.4 (6.0–18.4 µg/dL) |
| Adrenocorticotropic hormone | 6.2 (7.2–63.3 pg/mL) |
| Norepinephrine | |
| Plasma | 459 (80–520 pg/mL) |
| 24-hour urine | 75 (15–100 mcg/24 h) |
| Metanephrines | |
| Plasma, free | <25 (<57 pg/mL) |
| 24-hour urine | 97 (21–153 mcg/g cr) |
| Dehydroepiandrosterone sulfate | 29.0 (35.0–430.0 µg/dL) |
| Plasma renin activity | 0.65 (0.25–5.82 ng/mL/h) |
| Aldosterone, morning | <1 (≤28 ng/dL) |
| Lipase | 25 (11–55 U/L) |
| Troponin, high sensitivity | Negative |