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 Bcell
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.

Keywords : Lymphoma, Non-Hodgkin, Adrenal Insufficiency
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