Primary bilateral non-Hodgkin's lymphoma of the adrenal gland is a rare presentation with <200 reported cases. We report a 70-year-old man who presented with vomiting and abdominal pain for 2 weeks and was subsequently diagnosed to have high-grade lymphoma of the adrenal glands. The patient was then started on a rituximab-bendamustine chemotherapy regimen. The patient tolerated treatment well without significant side effects. Repeat positron emission tomography CT scan after four cycles of chemotherapy showed complete response. The patient has completed six cycles of chemotherapy and is on regular follow-up with no signs of relapse.
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