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Adrenal lymphoma causing primary hypoadrenalism in the elderly is a very rare finding. We describe a case of an 85-year-old man who was admitted to our hospital. He had a short history of hypotension and unresponsiveness. He was referred to the endocrine team, after a CT scan of his thorax abdomen and pelvis demonstrated significant enlargement of both his adrenal glands with associated lymphadenopathy. This scan was originally done to rule out an occult intra-abdominal malignancy. In addition, a tetracosactide (short Synacthen) test demonstrated adrenal insufficiency. This case demonstrates that adrenal lymphoma should be considered as an important differential when there is evidence of adrenal gland hyperplasia, lymphadenopathy and adrenal insufficiency. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Sentinel Lymph Node Biopsy in Malignant Melanoma" by J. M. Thomas in the April 26, 2008 issue.

Reports on a case of nausea and vomiting due to insulin glargine in a patient with type 1 diabetes mellitus. Case of a 34-year-old woman with no other illnesses who got nauseous on a basal bolus regime of Actrapid and insulin glargine; Withdrawal of the drug and subsequent retrial which started the nausea and vomiting again; Three other reports of similar side effects since the product was launched in the UK; Possibility the side effects could lead to diabetic ketoacidosis.