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[Incidental adrenal histoplasmosis].
Cecilia Nine1, Claudia Maidana Paz, Florencia Koch
1Servicio de Clínica Médica, Departamento de Medicina Interna, Hospital Alemán, Buenos Aires, Argentina.
Medicina
|January 21, 2003
Summary
Histoplasmosis can cause bilateral adrenal masses in asymptomatic individuals. This rare fungal infection should be considered in endemic areas, even in immunocompetent patients.
Area of Science:
- Endocrinology
- Infectious Diseases
- Radiology
Background:
- Adrenal masses discovered incidentally during abdominal imaging present diagnostic challenges.
- The case involves an asymptomatic patient with no prior medical history.
Observation:
- Abdominal ultrasonography revealed a 66 x 33 mm enlarged right adrenal gland.
- Computed tomography (CT) demonstrated bilateral, irregular enlargement of both adrenal glands.
- Initial assessments ruled out non-adrenal malignancies and hyperfunctioning tumors.
Findings:
- A CT-guided biopsy was performed for histopathologic examination.
- Histopathology confirmed the presence of histoplasmosis.
- The patient resided in a region endemic for histoplasmosis and had regular exposure to bird droppings.
Implications:
- Histoplasmosis is an uncommon but important cause of bilateral adrenal masses.
- This diagnosis should be considered in immunocompetent patients presenting with adrenal masses, particularly in endemic areas.
- Highlights the importance of considering infectious etiologies in adrenal pathology.