Non-Hodgkin's lymphoma of the adrenal glands with brain involvement

We report an usual case of non-Hodgkin's lymphoma involving both adrenal glands with brain infiltration. Masses in both adrenal glands were noted on utrasonography and computed tomography. Malignant infiltration of the glands by B large cell non-Hodgkin lymphoma was demonstrated by cytological findings in needle biopsy (Cells were CD45 and CD20 positives, CD3 and CD30negatives). Laboratory tests disclosed an elevated ACTH level and loss of cortisol circadial rythm. The involvement of both adrenal glands with non-Hodgkin's lymphoma is very rare, especially with non-Hodgkin lymphoma involvement the brain. In this report we want to emphasize that fine-needle aspiration biopsy was useful in the diagnosis. Primary adrenal lymphomas should be included in the differential diagnosis of suprarenal mass.