Primary adrenal lymphoma presenting as primary adrenal insufficiency

This is the authors' abstract. We don't add key points for this paper.

Although lymphoma may involve the adrenal glands as part of a generalised disease process, primary adrenal lymphoma is a rare entity. We present the case of a man in his late 60s who was admitted via the emergency department with clinical features consistent with adrenal failure. Initial investigations demonstrated anaemia, hypercalcaemia and adrenal insufficiency. Further biochemical work-up showed no evidence of an autoimmune or congenital aetiology of adrenal failure, and diagnostic imaging revealed bilateral adrenal enlargement. Adrenal biopsy revealed a diagnosis of diffuse large B-cell lymphoma. The patient achieved complete metabolic remission following first-line immunochemotherapy, though adrenal function remained compromised. We review the published literature and discuss diagnostic challenges in patients presenting with adrenal insufficiency of unclear aetiology.