ADRENAL INSUFFICIENCY WITH ENLARGED ADRENALS

Five patients with adrenal insufficiency and large adrenal glands at p resentation are reported. Addison's disease was due to adrenal tubercu losis in three patients, with important changes in adrenal configurati on on CT reflecting the natural history of the disease. Adrenal infilt ration by non-Hodgkin lymphoma and metastatic carcinoma of the lung wa s the cause of the disease in the fourth and fifth patients, respectiv ely, who developed signs of adrenal insufficiency before the diagnosis of the primary lesion became apparent. Histologic confirmation was es tablished after unilateral adrenalectomy in three patients. In two pat ients with adrenal tuberculosis, long clinical and laboratory follow-u p confirmed the diagnosis. This report indicates that Addison's diseas e is not infrequently associated with adrenal enlargement. Adrenal siz e is related to the cause and duration of the various disease states l eading to adrenal insufficiency. Moreover, adrenal insufficiency assoc iated with enlarged adrenal glands can be the presenting manifestation of lymphoma or metastasis.