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A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
Histoplasmosis mimicking adrenal carcinoma
Rajasreepai Ramachandra Pai1, Raghesh Varot Kangath2, Immanuel Thamban3
1Division of Endocrinology, Department of Internal Medicine, Baylor Scott & Whit e Health/Texas A&M Health Science Center College of Medicine, Temple, Texas, USA. drrajashree.pai@gmail.com
Objectives:
The incidence of unilateral adrenal histoplasmosis in nonendemic areas is rare. This is even rarer if the host is immunocompetent.
Methods:
We report a patient who was referred for unexplained weight loss who underwent a computed tomography scan of abdomen revealing a large unilateral adrenal nodule measuring 7.6 cm in size.
Results:
Hormonal workup was negative including urine 24-hour free metanephrines, and the patient underwent unilateral adrenalectomy. The pathology showed budding yeast that stained with Gomori's methenamine silver (GMS) revealed the diagnosis of adrenal histoplasmosis.
Conclusion:
We encourage clinicians to include infection by Histoplasma capsulatum as well as other granulomatous diseases and tumors in the differential diagnosis of unilateral adrenal enlargement even in immunocompetent hosts living in nonendemic areas.
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