Primary adrenal insufficiency masking as an adrenal B-cell lymphoma.

Abstract

We report here a woman in her 70s presenting with adrenal insufficiency secondary to a primary adrenal lymphoma. The patient had a previous history of aphthous ulcers on dexamethasone and was referred to endocrinology with symptoms of fatigue and orthostasis. Subsequent Cosyntropin stimulation showed primary adrenal insufficiency and adrenal CT demonstrated large infiltrative masses. Adrenal biopsy confirmed the diagnosis of primary adrenal lymphoma of the B-cell type. This case demonstrates the importance of including lymphoma in the differential diagnosis of adrenal insufficiency, particularly in the elderly population and in the setting of negative 21-hydroxlyase antibody results.

• Authors: Eric Kuhn, John R Sanchez, Mohamed Km Shakir, Thanh Duc Hoang
• Journal: BMJ case reports (BMJ Case Rep) Vol. 15 Issue 9 (Sep 27 2022) ISSN: 1757-790X [Electronic] England
• PMID: 36167431 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Limited 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Cosyntropin
• Dexamethasone

Topics

• Addison Disease (diagnosis)
• Adrenal Gland Neoplasms (complications, diagnosis)
• Adrenal Insufficiency (complications, etiology)
• Aged
• Cosyntropin
• Dexamethasone (therapeutic use)
• Female
• Humans
• Lymphoma (diagnosis)
• Lymphoma, B-Cell (complications, diagnosis)
• Tomography, X-Ray Computed