title: Primary adrenal lymphoma with paraneoplastic syndrome.
abstract: BACKGROUND
  The adrenal gland is a common site for neoplastic diseases and primary adrenal lymphoma (PAL) is a rare tumor with around 120 cases reported so far.
  
  
  METHODS
  We present a rare case of 76-year-old male who presented with headache, confusion, inappropriate body movements and abdominal pain. Adrenal biopsy revealed PAL and he has had an excellent neurologic outcome to date with chemotherapy and involved field radiation.
  
  
  CONCLUSIONS
  The majority of cases of PAL are B cell lymphomas with diffuse large cell in 70% of cases. Clinical symptoms are variable and patients may present with abdominal pain, fever, anorexia, weight loss, fatigue or symptoms of adrenal insufficiency. Therapeutic modalities for PAL include surgery, chemotherapy and radiotherapy and corticosteroid replacement. With this case report, we hope to raise awareness about this rare disease and to include lymphoma in the differential of adrenal masses.
authors.affiliation: Department of Internal Medicine, University of Alabama at Birmingham, WP P230, Birmingham, Alabama 35249-7331, USA.
authors.forename: Radhika
authors.initials: R
authors.lastname: Dasararaju
authors.affiliation: Hematology-Oncology, Montgomery Cancer Center, Montgomery, Alabama 36107, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Avery
keywords: Diffuse large B cell lymphoma; Encephalopathy; Paraneoplastic syndrome; Primary adrenal lymphoma