An unusual cause of bilateral adrenal incidentalomas with primary adrenal lymphoma; a case report

Abstract

Although lymphoma can sometimes involve the extra-nodal tissues such as adrenal glands, bilateral adrenal incidentaloma with primary adrenal lymphoma is very rare. We present a 34-year-old man with abdominal discomfort, huge bilateral adrenal masses in CT scan and adrenal insufficiency by cosyntropin test. Routine investigation revealed normal K, Na and elevated serum lactate dehydrogenase (LDH). Large B-cell lymphoma was confirmed by adrenal CT guided biopsy and histopathology. Then the patient was treated with R-CHOP regimen chemotherapy protocol lonely, needless from surgery which resulted in significant reduction in adrenal masses

Keywords: Primary adrenal lymphoma, Adrenal insufficiency, Adrenal mass