Non-Hodgkin lymphoma with adrenal insufficiency: a case report and literature review.

A 62-year-old Thai man was admitted because of nausea and vomiting with incidentally detected bilateral adrenal enlargement. The basal cortisol was low and ACTH level was elevated CT guided percutaneous needle biopsy of adrenal gland showed a diffuse infiltration of medium to large atypical lymphoid cells of B-cell immunophenotype, which are diagnostic for a diffuse large B-cell lymphoma. Involvement by large B-cell lymphoma was documented in bone marrow biopsy as well. The findings confirmed the diagnosis of primary adrenal insufficiency caused by large B-cell lymphoma involving both adrenal glands.