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Histoplasmosis presenting as bilateral adrenal masses: cytomorphological diagnosis of three cases

Arvind Ahuja1, Sandeep R Mathur, Venkateshwaran K Iyer

  • 1Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

Diagnostic Cytopathology
|March 10, 2011
PubMed

Insights

Histoplasmosis, a fungal infection, can rarely cause bilateral adrenal masses in immunocompetent individuals. Fine-needle aspiration confirmed this unusual presentation, highlighting fungal infection as a key differential diagnosis.

Area of Science:

  • Infectious Diseases
  • Mycology
  • Endocrinology

Background:

  • Histoplasmosis is a global fungal infection caused by Histoplasma capsulatum spores.
  • Adrenal involvement typically occurs in disseminated disease among immunocompromised patients.
  • Bilateral adrenal masses as the primary presentation in immunocompetent individuals are exceptionally rare.

Observation:

  • Three cases of immunocompetent patients presenting with bilateral adrenal masses were identified.
  • Fine-needle aspiration (FNA) under ultrasonographic (USG) guidance was utilized for diagnosis.
  • Histoplasmosis was confirmed as the cause of the adrenal masses.

Findings:

  • This study highlights an unusual presentation of histoplasmosis.
  • FNA proved effective in diagnosing adrenal histoplasmosis.
  • The cases demonstrate that localized fungal infection should be considered in bilateral adrenal masses, even in immunocompetent patients.

Implications:

  • Clinicians should consider fungal infections in the differential diagnosis of bilateral adrenal masses.
  • Ultrasonography-guided FNA is a valuable tool for diagnosing adrenal lesions.
  • This finding expands the understanding of Histoplasma capsulatum's potential clinical manifestations.

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