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CC BY-NC-ND 4.0 · Journal of Diabetes and Endocrine Practice 2020; 03(01): 9-11
DOI: 10.4103/jdep.jdep_18_19
Case Report

Primary adrenal insufficiency secondary to bilateral adrenal lymphoma

Zahra Ghareeb
Department of Internal Medicine, Qatif Central Hospital, Qatif
,
Shatha Alfaraj
1   Department of Histopathology, Qatif Central Hospital, Qatif
,
Zainab Alnaji
Department of Internal Medicine, Qatif Central Hospital, Qatif
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Involvement of adrenal glands in lymphoma is rare; the patient may have variable presentations. We report a case of a 62-year-old Saudi female who presented to our center with a few-week history of fatigue, weight loss, subjective fever, and a recent change in skin color. On examination, she looked dehydrated and had a drop in blood pressure with postural change and hyperpigmentation of the skin of the face and hands. Morning cortisol levels were low, and adrenocorticotropic hormone levels were high, which indicated primary adrenal insufficiency (PAI). An adrenal computed tomography (CT) scan revealed bilateral adrenal enlargement. After excluding pheochromocytoma, a CT scan-guided trucut biopsy of the adrenals confirmed non-Hodgkin lymphoma. The patient was started on steroid replacement therapy, and after stabilization, a plan was made to initiate chemotherapy for the treatment of lymphoma; unfortunately, the patient died shortly after diagnosis because of rapid progression of the disease. Adrenal lymphoma can present with PAI and should be considered in the presence of bilateral adrenal enlargement; it is an aggressive tumor and carries poor prognosis if the treatment is delayed.

Keywords

Adrenal - bilateral - lymphoma - primary

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Publication History

Received: 15 December 2019

Accepted: 02 February 2020

Article published online:
16 June 2022

© 2020. Gulf Association of Endocrinology and Diabetes (GAED). All rights reserved. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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