cosyntropin and Lymphoma--T-Cell

We describe a case of a 42 year old male who presented with Addison's disease resulting from primary lymphoma of the adrenals. Our case and a review of the literature indicates that this distinct entity has some unique clinical and radiologic features. In this entity, the lymphoma tends to be extranodal and have a poor prognosis. In addition, the computed tomography (CT) images have the unique appearance of enlargement of the adrenal gland with maintenance of the adreniform shape. We suggest that primary adrenal lymphoma is a distinct clinical entity and should be considered in patients with an elevated serum lactate dehydrogenase, characteristic CT findings and Addison's disease.

Topics: Addison Disease; Adrenal Cortex Neoplasms; Adrenal Gland Diseases; Adult; Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Cosyntropin; Cyclophosphamide; Dexamethasone; Diagnosis, Differential; Doxorubicin; Etoposide; Eye Neoplasms; Fatal Outcome; Humans; Hydrocortisone; Hyperkalemia; Ifosfamide; L-Lactate Dehydrogenase; Lymphoma, T-Cell; Male; Methotrexate; Neoplasm Proteins; Oculomotor Muscles; Prednisone; Tomography, X-Ray Computed; Tuberculosis, Endocrine; Vincristine