{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T01:55:46Z","timestamp":1793066146568,"version":"4.5.0"},"reference-count":11,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,6,6]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:p>Extranodal adrenal involvement in non-Hodgkin\u2019s lymphoma is very rare, estimated to be around less than 0.2%. Most common sites involved are stomach, intestine and testis. It is very rare for adrenal tumours to present as primary adrenal insufficiency, with an incidence of around 1.2% in patients diagnosed with adrenal masses. Diffuse large B cell lymphoma (DLBL) originating from the stomach and metastasizing to bilateral adrenal glands is an extremely uncommon occurrence with only three cases found on review of the literature. We present a case of a 62-year-old African\u2013American man who presented with nausea, vomiting, abdominal pain and hypotension, later being diagnosed as DLBL of the gastric antrum metastasized to bilateral adrenal glands. Initial laboratory workup revealed including hormonal analysis and cosyntropin test revealed adrenal insufficiency. The patient later died during the hospitalisation after developing respiratory failure, severe hypotension refractory to vasopressors and severe metabolic acidosis.<\/jats:p>","DOI":"10.1136\/bcr-2019-229758","type":"journal-article","created":{"date-parts":[[2019,7,4]],"date-time":"2019-07-04T09:36:30Z","timestamp":1562232990000},"page":"e229758","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Gastric diffuse large B-cell lymphoma with bilateral adrenal metastasis"],"prefix":"10.1136","volume":"12","author":[{"given":"Muhammad","family":"Hassan","sequence":"first","affiliation":[{"name":"Interfaith Medical Center, Brooklyn, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5873-5443","authenticated-orcid":false,"given":"Amrendra Kumar","family":"Mandal","sequence":"additional","affiliation":[{"name":"Interfaith Medical Center, Brooklyn, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasdeep Singh","family":"Sidhu","sequence":"additional","affiliation":[{"name":"Interfaith Medical Center, Brooklyn, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luz Maria","family":"Cardenas","sequence":"additional","affiliation":[{"name":"American University of Antigua College of Medicine, New York City, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,7,3]]},"reference":[{"key":"2025082721593925000_12.7.e229758.1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197201)29:1<252::AID-CNCR2820290138>3.0.CO;2-#"},{"key":"2025082721593925000_12.7.e229758.2","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.5858\/arpa.2018-0275-RA","article-title":"Update on gastrointestinal lymphomas","volume":"142","author":"Weindorf","year":"2018","journal-title":"Arch Pathol Lab Med"},{"key":"2025082721593925000_12.7.e229758.3","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.cancergen.2018.08.001","article-title":"Primary extranodal diffuse large B-cell lymphomas: Many sites, many entities? 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