Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2018) 59 EP13 | DOI: 10.1530/endoabs.59.EP13

SFEBES2018 ePoster Presentations Adrenal and steroids (19 abstracts)

A rare cause of unexpected bilateral adrenal gland abnormalities

Kerri Devine 1 , Andy James 2 & Stuart Bennett 1


1North Tyneside Hospital, Northumberland, UK; 2Royal Victoria Infirmary, Newcastle, UK.


Adrenal gland anomalies are common incidental findings when imaging tests are performed for other reasons, but are usually unilateral. We present a case where bilaterally abnormal adrenal glands held the key to a rare diagnosis. A 79 year old female ex-smoker with a background of Type 2 Diabetes Mellitus and hypertension presented to our emergency department with a four month history of falls and progressive decline in mobility. Examination revealed evidence of weight loss, with grade 3/5 power and hyporeflexia in both lower limbs. She was hyponatraemic (sodium 117 mmol/L), attributed to taking bendroflumethiazide and amitriptyline, and anaemic with a detectable paraprotein. Early morning cortisol was within acceptable limits (665 nmol/L). Spinal imaging revealed degenerative disc disease, a small lung nodule and bilateral adrenal enlargement (5 cm). Nerve conduction studies confirmed a large fibre sensorimotor axonal abnormality. Suspecting metastatic bronchial malignancy, the patient eventually underwent adrenal biopsy which gave the diagnosis of Primary Adrenal Lymphoma (of diffuse large B cell type). After a short trial of chemotherapy she unfortunately deteriorated and died within 6 weeks of diagnosis. Primary adrenal lymphoma is a very rare form of extranodal non-Hodgkin’s disease, with <200 cases reported worldwide. It is usually bilateral, highly aggressive and associated with primary adrenal failure. Lymphoma should be considered in the differential diagnosis of adrenal lesions, particularly when bilateral.

Volume 59

Society for Endocrinology BES 2018

Glasgow, UK
19 Nov 2018 - 21 Nov 2018

Society for Endocrinology 

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