Primary bilateral adrenal lymphoma revealed by hemophagocytic syndrome. 
Primary adrenal lymphoma is rare.  It is often bilateral and in most of the cases of B-cell type.  The clinical features are various and not specific.  We report a case of a 69-year-old woman who had a diffuse large B-cell lymphoma associated with hemophagocytic syndrome.  The abdominal imaging reveals the existence of bilateral adrenal hypertrophy.  A CT scan-guided biopsy concluded to a diffuse large B-cell lymphoma CD 20-positive associated EBV.  The treatment consisted on "CHOP like" chemotherapy associated with rituximab.  Primary adrenal lymphoma has a poor prognosis, even more poorly if associated with hemophagocytic syndrome.