Below is an instruction from Human. Write a response.
    ### Instruction:
    What is (are) primary macronodular adrenal hyperplasia ?
    ### Response:
    Primary macronodular adrenal hyperplasia (PMAH) is a disorder characterized by multiple lumps (nodules) in the adrenal glands, which are small hormone-producing glands located on top of each kidney. These nodules, which usually are found in both adrenal glands (bilateral) and vary in size, cause adrenal gland enlargement (hyperplasia) and result in the production of higher-than-normal levels of the hormone cortisol.
    