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Case Reports
. 2016 Oct 26:2016:bcr2016217417.
doi: 10.1136/bcr-2016-217417.

Bilateral primary adrenal lymphoma with adrenal insufficiency

Aishah Ekhzaimy  1 , Ahmad Mujamammi  2
Affiliations
Case Reports

Bilateral primary adrenal lymphoma with adrenal insufficiency

Aishah Ekhzaimy et al. BMJ Case Rep. .

Abstract

Primary adrenal lymphoma is an extremely rare condition. We describe a case of bilateral adrenal lymphoma in a man aged 55 years who was admitted to our hospital. He had a 3-month history of left flank pain, nausea and vomiting with weight loss. A CT scan at a private hospital revealed bilateral large adrenal masses; the patient was referred to our centre based on these findings. He was evaluated for pheochromocytoma by an endocrinology team; however, all findings were negative. In addition, a cosyntropin stimulation test indicated adrenal insufficiency. A Trucut biopsy of the adrenal gland revealed diffuse large B-cell lymphoma of the adrenal glands, and the patient responded extremely well to chemotherapy.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
CT scans of the abdomen. (A) Large, bilateral, heterogeneously enhanced suprarenal masses. The right and left masses measured 6×7×6 and 10.6×6.3×8.7 cm3, respectively, with no observed calcification. (B) A postchemotherapy CT scan revealed significant interval regression in the sizes of the previously observed bilateral adrenal masses, with restoration of their configurations.
Figure 2
Figure 2
(A and B) MRI scan: bilateral large well-defined heterogeneous mass lesion seen at the region of both adrenal glands (red arrows) with rather lobulated outline, measuring about 7.5×5.5 cm2, in the right side and about 8.5×7 cm2, in the left side. The lesion displayed intermediate to low signal intensity on T1WI images and high signal on T2WI images with fluid restriction on diffusion-weighted images (no intravenous contrast was given).
Figure 3
Figure 3
Gallium-67 whole-body scans. (A and B) Positive uptake in both adrenal glands. (C and D) A postchemotherapy gallium-67 whole-body scan was negative.
See this image and copyright information in PMC

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