title: Adrenal insufficiency caused by primary aggressive non-Hodgkin's lymphoma of bilateral adrenal glands: report of a case and literature review.
abstract: A 64-year-old woman was hospitalized because of poor general condition, gastrointestinal upset, unexplained fever, electrolyte imbalances, and an incidental finding of bilateral huge adrenal masses on computerized tomography (CT) of the abdomen. Non-Hodgkin's lymphoma (NHL) of B-cell origin was proven by ultrasound-guided aspiration biopsy of the left adrenal gland. Meanwhile, primary adrenal insufficiency was confirmed by her low serum cortisol level, high ACTH level, and inadequate adrenal response to the rapid ACTH stimulation test. The diagnosis of primary adrenal NHL was supported by detailed physical examinations, bone marrow examination, and such imaging studies as CT scan and sonography. She received three courses of chemotherapy with cyclophosphamide, vincristine, and prednisolone and there was an initial transient response, but she died of sepsis and progression of NHL three and a half months later.
authors.affiliation: Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: C W
authors.initials: CW
authors.lastname: Hsu
authors.forename: C L
authors.initials: CL
authors.lastname: Ho
authors.forename: W H
authors.initials: WH
authors.lastname: Sheu
authors.forename: H J
authors.initials: HJ
authors.lastname: Harn
authors.forename: T Y
authors.initials: TY
authors.lastname: Chao
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D000311:Adrenal Glands / Q000000981:diagnostic imaging / Q000473:pathology; D000309:Adrenal Insufficiency / Q000097:blood / Q000209:etiology*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001707:Biopsy, Needle; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone