Primary non-Hodgkin's malignant lymphoma of the adrenal gland. Case reportand review of the literature.

Primary lymphoma of the adrenal gland is an exceptional site for non-Hodgki n's malignant lymphoma, as fewer than 50 cases have been reported in the in ternational literature. To our knowledge this is the first reported case of intraoperative discovery. The diagnosis of primary adrenal lymphoma can be suggested in the case of b ilateral involvement and adrenal insufficiency bur there are no specific cl inical or complementary criteria. The main differential diagnoses are adren al metastases and adenomas. Management is often that of an incidentaloma. Primary NHML of the adrenal gland has a poor prognosis with a mean survival of 15 months. Only one case with a survival of 8 years has been reported i n a patient treated with adjuvant radiotherapy, while basic treatment consi sts of combination chemotherapy. Our patient was treated by adrenalectomy followed by close surveillance.