Journal
BMJ CASE REPORTS
Volume 15, Issue 9, Pages -Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/bcr-2022-250973
Keywords
endocrine system; haematology (drugs and medicines); adrenal disorders; haematology (incl blood transfusion); oncology
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This case highlights the importance of considering lymphoma in the differential diagnosis of adrenal insufficiency, especially in the elderly population and in cases with negative 21-hydroxlyase antibody results.
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.
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