Successful treatment of primary adrenal non-Hodgkin's lymphoma associated with adrenal insufficiency

We report a case of primary adrenal NHL associated with adrenal insufficien cy which was successfully treated with steroid replacement and chemotherapy . A 69-year-old woman hospitalized with fatigue and weight loss developed s hock and recovered with steroid therapy. Adrenal insufficiency was confirme d by an elevated plasma adrenocorticotropic hormone level and low cortisol, Computed tomography revealed large bilateral adrenal masses. Needle biopsy showed a diffuse, mixed B cell lymphoma. CHOP therapy accompanied by stero id replacement was begun, and she achieved a complete remission after 4 cyc les. She received additional 4 cycles of chemotherapy, Although adrenal ins ufficiency was irreversible, she has continued in complete remission for 50 months at this reporting.