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Unilateral Adrenal Cryptococcosis on FDG PET/CT
1From the Departments of *Nuclear Medicine, and †Pathology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Clinical Nuclear Medicine
|April 4, 2017
Summary
A T-cell deficient patient presented with adrenal mass symptoms. Diagnosis revealed adrenal cryptococcosis, a rare fungal infection, after surgical removal and testing.
Area of Science:
- Medical Mycology
- Adrenal Pathology
- Nuclear Medicine Imaging
Background:
- T-cell deficiency can predispose individuals to opportunistic infections.
- Adrenal masses require thorough investigation to rule out malignancy and identify underlying causes.
- Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) is crucial for characterizing adrenal lesions.
Observation:
- A 70-year-old male with T-cell deficiency presented with persistent right waist pain and low-grade fever.
- Abdominal CT revealed a large right adrenal mass.
- FDG PET/CT demonstrated increased FDG uptake within the adrenal mass, suggesting malignancy or inflammation.
Findings:
- Surgical resection (adrenalectomy) of the right adrenal mass was performed.
- Postoperative pathological and microbial examinations confirmed adrenal cryptococcosis.
- This rare fungal infection was the cause of the adrenal mass and associated symptoms.
Implications:
- Adrenal cryptococcosis should be considered in the differential diagnosis of adrenal masses, especially in immunocompromised patients.
- FDG PET/CT can aid in the initial characterization of adrenal lesions but definitive diagnosis requires histopathology and microbial analysis.
- Early identification and treatment of opportunistic fungal infections in T-cell deficient individuals are critical for patient outcomes.