Adrenal diffuse large B‐cell lymphoma with high PD‐L1 expression: Two case reports and literature review

BACKGROUND: Primary adrenal lymphoma (PAL) is an infrequent malignant disease and there is no consensus classification or specialized treatment for it. However, PAL has been observed to have worse prognosis compared with other extrarenal malignant lymphomas and diffuse large B‐cell lymphoma presents as the most common subtype of PAL. METHODS: The current study reported two cases of adrenal diffuse large B‐cell lymphoma with high PD‐L1 expression and discussed the clinical significance of PD‐L1 through literature review. KEY RESULTS: The PD‐L1 expression rate of the two cases was 90% and 80%, respectively, which was significantly higher than those reported in the literature. CONCLUSION: PAL is a type of non‐Hodgkin's lymphoma with low incidence and poor prognosis, and it is necessary to further explore the early use of immunological checkpoint inhibitors for patients with higher expression of PD‐L1 and with rituximab‐resistance.