{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:16:52Z","timestamp":1790615812676,"version":"4.1.0"},"reference-count":16,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,9,13]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>Although lymphoma may involve the adrenal glands as part of a generalised disease process, primary adrenal lymphoma is a rare entity. We present the case of a man in his late 60s who was admitted via the emergency department with clinical features consistent with adrenal failure. Initial investigations demonstrated anaemia, hypercalcaemia and adrenal insufficiency. Further biochemical work-up showed no evidence of an autoimmune or congenital aetiology of adrenal failure, and diagnostic imaging revealed bilateral adrenal enlargement. Adrenal biopsy revealed a diagnosis of diffuse large B-cell lymphoma. The patient achieved complete metabolic remission following first-line immunochemotherapy, though adrenal function remained compromised. We review the published literature and discuss diagnostic challenges in patients presenting with adrenal insufficiency of unclear aetiology.<\/jats:p>","DOI":"10.1136\/bcr-2025-269999","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:30:34Z","timestamp":1790613034000},"page":"e269999","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Primary adrenal lymphoma presenting as primary adrenal insufficiency"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7042-8844","authenticated-orcid":false,"given":"Khaled","family":"Ahmed","sequence":"first","affiliation":[{"name":"Endocrine and Diabetes, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efstratios","family":"Stratos","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospital, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Saada","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospital, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospital, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2490-8342","authenticated-orcid":false,"given":"Khin S","family":"Myint","sequence":"additional","affiliation":[{"name":"Endocrine and Diabetes, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK"},{"name":"Norfolk and Norwich University Hospital, Norwich, UK"},{"name":"School of Medicine, University East Anglia, Norwich, 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