Sudden unexpected death with primary adrenal lymphoma.

•We describe an 82-year-old male autopsy case of sudden unexpected death (SUD) with a clinical history of non-severe aortic stenosis (AS).•He showed general fatigue, anorexia associated with intermittent mild fever and rare vomiting in the month before SUD.•Autopsy showed primary adrenal lymphoma (PAL) in both adrenal glands, in addition to AS.•This case shows that adrenal insufficiency associated with PAL may be rare but a significant factor for SUD.