Primary Bilateral Adrenal T-Cell Lymphoma: A Case Report

Primary adrenal lymphoma is an extremely rare entity which constitutes less than 1% of all extranodal lymphomas. Most cases are presented with bilateral adrenal masses with or without extra-adrenal involvement. Presentation may be with adrenal insufficiency which can be a life-threatening situation. The etiological mechanism is not completely understood but autoimmunity seems to have an important role. We report a case of a 44-year old man admitted to the Internal Medicine Department due to thoracic pain, constitutional symptoms and fever. An abdominal computed tomography scan revealed bilateral adrenal masses. A left surgical adrenalectomy was performed, and histological examination diagnosed a non-Hodgkin T-cell lymphoma. Only 5 cases of T-cell type PAL have been reported in literature. This case report emphasizes the complexity of differential diagnosis in the presence of bilateral adrenal masses, the possibility of lymphoma and the importance of early diagnosis in order to improve the clinical outcomes. A review of the literature of this unusual entity was carried out.