Journal of Korean Endocrine Society 2000;15(1):121-127.
Published online January 1, 2001.
Two Cases of Malignant Lymphoma Involving Bilateral Adrenal Glands as Huge Masses.
Seung Hyeok Han, Jin Seok Kim, Myung Soo Kim, Hye Won Chung, Jae Ho Jung, Young Suck Goo, Chul Woo Ahn, Jae Hyun Nam, Sang Soo Jung, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh, Jee Sook Hahn
Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, Korea.
Abstract
Adrenal gland is a common site of metastatic tumors such as breast cancer, lung cancer, and colon cancer. When adrenal mass is found incidentally, adenoma is the most common among single adrenal masses. But in the case of bilateral adrenal masses, infection, bilateral metastases and hemorrhage are common. Secondary involvement of the adrenal gland is found in 25% of autopsy cases of non-Hodgkin's lymphoma. However, adrenal insufficiency is rare because it becomes apparent only when approximately 90% of adrenal cortex is destructed. We exprienced two cases of malignant lymphoma which involved the adrenal glands bilaterally. One case in which adrenal insufficiency was suspicious, was accompanied by hypovolemic shock and sepsis at the initial presentation. He died of sepsis combined with DIC even though hydrocortisone, intravenous saline infusion, and antibiotics therapy were started immediately. The other one was found incidentally, in which adrenal infiltraion was confirmed by CT scan. Hormonal level was normal and adrenal masses disappeared after chemotherapy.
Key Words: Adrenal gland, Malignant lymphoma, Adrenal insufficiency


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