title: Primary adrenal lymphoma associated with adrenal insufficiency: a distinct clinical entity.
abstract: We describe a case of a 42 year old male who presented with Addison's disease resulting from primary lymphoma of the adrenals. Our case and a review of the literature indicates that this distinct entity has some unique clinical and radiologic features. In this entity, the lymphoma tends to be extranodal and have a poor prognosis. In addition, the computed tomography (CT) images have the unique appearance of enlargement of the adrenal gland with maintenance of the adreniform shape. We suggest that primary adrenal lymphoma is a distinct clinical entity and should be considered in patients with an elevated serum lactate dehydrogenase, characteristic CT findings and Addison's disease.
authors.affiliation: Department of Medicine, University of Manitoba, Winnipeg, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Pimentel
authors.forename: J B
authors.initials: JB
authors.lastname: Johnston
authors.forename: D R
authors.initials: DR
authors.lastname: Allan
authors.forename: H
authors.initials: H
authors.lastname: Greenberg
authors.forename: C N
authors.initials: CN
authors.lastname: Bernstein
mesh_terms: D000224:Addison Disease / Q000097:blood / Q000209:etiology*; D000306:Adrenal Cortex Neoplasms / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D000307:Adrenal Gland Diseases / Q000175:diagnosis; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D003366:Cosyntropin; D003520:Cyclophosphamide / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005134:Eye Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006947:Hyperkalemia / Q000209:etiology; D007069:Ifosfamide / Q000008:administration & dosage; D007770:L-Lactate Dehydrogenase / Q000097:blood; D016399:Lymphoma, T-Cell / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D009363:Neoplasm Proteins / Q000097:blood; D009801:Oculomotor Muscles / Q000000981:diagnostic imaging / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D014383:Tuberculosis, Endocrine / Q000175:diagnosis; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D003366:Cosyntropin; D014750:Vincristine; D005047:Etoposide; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide; D007770:L-Lactate Dehydrogenase; D007069:Ifosfamide; D011241:Prednisone; D006854:Hydrocortisone; D008727:Methotrexate