{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T18:18:14Z","timestamp":1783448294889,"version":"3.55.0"},"reference-count":10,"publisher":"Bioscientifica","issue":"1","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":165,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Primary adrenal lymphoma (PAL) is a rare malignancy typically considered in patients presenting with features of adrenal insufficiency and bilateral adrenal gland enlargement. Early diagnosis and differentiation from other causes of bilateral adrenal masses are essential to guide appropriate management. Prompt initiation of chemotherapy can significantly improve survival outcomes. We present the case of a 72-year-old patient with adrenal insufficiency and imaging-confirmed large bilateral adrenal masses with widespread lymph node involvement. Core biopsy of the adrenal mass confirmed high-grade diffuse large B-cell lymphoma (DLBCL), consistent with a diagnosis of PAL. She was initially managed with systemic chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP), achieving a complete metabolic response. Two months later, she presented with relapsed central nervous system disease and died despite intrathecal cytarabine and methotrexate chemotherapy. Given the rarity of this condition, we use the case to illustrate and discuss key aspects of PAL, including demographics, pathogenesis, diagnosis, management, and prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1530\/edm-25-0148","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T12:17:50Z","timestamp":1771503470000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":0,"title":["Bilateral adrenal masses and adrenal insufficiency: a rare case of primary adrenal lymphoma"],"prefix":"10.1530","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0068-4767","authenticated-orcid":true,"given":"Aya","family":"Eladl","sequence":"first","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Michaelidou","sequence":"additional","affiliation":[{"name":"2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Gibb","sequence":"additional","affiliation":[{"name":"3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faye","family":"Sharpley","sequence":"additional","affiliation":[{"name":"4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safwaan","family":"Adam","sequence":"additional","affiliation":[{"name":"2"},{"name":"5"},{"name":"6"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"2026070713561438000_bib1","first-page":"635","article-title":"Adrenal lymphoma: presentation, management and prognosis","volume":"109","author":"Laurent","year":"2016","journal-title":"QJM"},{"key":"2026070713561438000_bib2","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1507\/endocrj.K08E-035","article-title":"Bilateral primary adrenal non-Hodgkin\u2019s lymphoma and primary adrenocortical carcinoma \u2013 review of the literature preoperative differentiation of adrenal tumors","volume":"55","author":"Ozimek","year":"2008","journal-title":"Endocr J"},{"key":"2026070713561438000_bib3","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.1007\/s00277-013-1812-3","article-title":"Primary adrenal lymphoma: a systematic review","volume":"92","author":"Rashidi","year":"2013","journal-title":"Ann Hematol"},{"key":"2026070713561438000_bib4","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.ciresp.2016.05.004","article-title":"Primary adrenal lymphoma; 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