We describe an unusual case of non-Hodgkin's lymphoma of the adrenals which presented as Addison's disease. Examination of tissue taken by computed tomography guided biopsy revealed a high grade B cell centroblastic lymphoma. The patient was treated with chemotherapy but died from invasive aspergillosis. Autopsy confirmed bilateral adrenal involvement by lymphoma.
Non-Hodgkin's lymphoma (NHL) is malignancies of white blood cells called lymphocytes. Although fever and weight loss are the main symptoms associated, NHL is known for its unusual presentation. Variants of NHL include diffuse large B cell, Mantle cell, Burkitt's Lymphoma, Precursor B cell type, and among many. At times, paraneoplastic diseases often mask the underlying lymphoma and hence delaying the diagnosis. Through this case series, we discuss the association of NHL with paraneoplastic diseases. NHL was associated with dorsal myelitis in the first case, metastatic spread in abdomen in the second case and with Steven Johnson syndrome in the third case.
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