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Gastric diffuse large B-cell lymphoma with bilateral adrenal metastasis
  1. Muhammad Hassan1,
  2. Amrendra Kumar Mandal1,
  3. Jasdeep Singh Sidhu1 and
  4. Luz Maria Cardenas2
  1. 1 Interfaith Medical Center, Brooklyn, New York, USA
  2. 2 American University of Antigua College of Medicine, New York City, New York, USA
  1. Correspondence to Dr Muhammad Hassan, dr.hassanzulfiqar{at}


Extranodal adrenal involvement in non-Hodgkin’s 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–American 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.

  • endocrine system
  • gastroenterology
  • oncology
  • endocrine cancer
  • gastric cancer
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  • Contributors MH was responsible for conception and design of the study. All authors were involved in data gathering, literature review, analysis of data and writing of the initial manuscript. All authors edited and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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