title: A case of non-Hodgkin's lymphoma primary arising in both adrenal glands associated with adrenal failure.
abstract: It is known that adrenal insufficiency is one of the complications in primary adrenal lymphoma, especially those with bilateral adrenal involvement. A 73-year-old man was referred for general fatigue and high fever to the nearest hospital. The patient was transferred to our hospital for evaluation of bilateral adrenal tumors and hyponatremia. He was diagnosed as having non-Hodgkin's lymphoma (NHL) with primaries arising in both adrenal glands. Primary adrenal lymphoma (PAL) is a rare extra-nodal NHL. Although an appropriate treatment of this disease has not been established, our case has demonstrated that the combination of rituximab and THP-COP chemotherapy could be administered, and that it improved clinical manifestations. This case raises the suggestion that malignant lymphoma should be suspected in patients with bilateral adrenal tumors that present with progressive adrenal insufficiency.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa, 761-0793, Japan.
authors.forename: Takamasa
authors.initials: T
authors.lastname: Nishiuchi
authors.forename: Hitomi
authors.initials: H
authors.lastname: Imachi
authors.forename: Mako
authors.initials: M
authors.lastname: Fujiwara
authors.forename: Koji
authors.initials: K
authors.lastname: Murao
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Onishi
authors.forename: Tohru
authors.initials: T
authors.lastname: Kiguchi
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Takimoto
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kushida
authors.forename: Reiji
authors.initials: R
authors.lastname: Haba
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ishida
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D000309:Adrenal Insufficiency / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D000368:Aged; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000150:complications / Q000175:diagnosis* / Q000473:pathology