A Case of primary adrenal lymphoma presenting with adrenal insufficiency

Non-Hodgkin lymphoma (NHL) with secondary involvement of the adrenal gland is not uncommon, however primary adrenal lymphoma leading to adrenal insufficiency is a rare occurrence. We report a case of primary adrenal lymphoma (PAL) that presented with adrenal insufficiency. Presence of persistent hyponatremia lead to the diagnosis of adrenal insufficiency. Computerized Tomography revealed the presence of bilateral large adrenal masses without lymphadenopathy or other organ involvement and histology confirmed the diagnosis of diffuse Non-Hodgkin B Cell Lymphoma. He was given hydrocortisone replacement therapy and was referred for chemotherapy though he died due to the poor prognosis of this malignancy.