Fine Needle Aspiration Cytology in Bilateral Adrenal Masses in a 58-Year-Old Man

Gopal, K.; Singh, Sompal; Gupta, Ruchika

doi:10.1159/000325018

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…[9] H. capsulatum is an intracellular dimorphic fungus which is commonly seen within the cytoplasm of the macrophages and exhibit narrow based budding. [10–12] In fine-needle aspiration smears, these organism can also be seen extracellularly as the fragile cytoplasm of the macrophages may get disrupted at the time of making smears. In our two cases, there was necrosis in the smears which may have resulted in their presence extracellularly scattered throughout the necrotic material.…”

Section: Discussionmentioning

confidence: 99%

“…These fungi can also be easily identified at the time of onsite adequacy evaluation in contrary to previous data which suggest that it is difficult to appreciate on routine cytological stains. [10–12] Rapid onsite cytopathological evaluation can suggest immediate diagnosis of the infection and hence the treatment can be started at the earliest. [11] Although this was not performed in our cases, the diagnosis was obtained the next day permitting prompt institution of treatment.…”

Section: Discussionmentioning

confidence: 99%

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Adrenal histoplasmosis: An unusual cause of adrenomegaly

et al. 2011

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Histoplasmosis is a geographically restricted form of fungal infection. Adrenal involvement is seen in disseminated disease but sometimes it may be the only site of demonstrable disease. Early diagnosis and treatment may save the patient from catastrophic adrenal insufficiency. We present two patients showing bilateral adrenomegaly on ultrasonography and contrast-enhanced CT, and was diagnosed to have histoplasmosis on fine-needle aspiration cytology.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adrenal histoplasmosis: An unusual cause of adrenomegaly

et al. 2011

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“…Percutaneous biopsy or FNAC using either CT or USG guidance is necessary for evaluating adrenal lesion, which exhibit typical microscopic features of histoplasma capsulatum. Histoplasma capsulatum is an intracellular dimorphic fungus which is usually seen in the macrophages cytoplasm and exhibits narrow based budding [12,13].…”

Section: Discussionmentioning

confidence: 99%

Adrenal histoplasmosis in an immunocompetant Individual– a rare case report

et al. 2016

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Introduction: Disseminated histoplasmosis is common particularly among immunocompromised individuals, alcoholics and extremes of age. It is of concern because of the associated high morbidity and mortality. Asymptomatic adrenal involvement has also been described in 30 to 50% of patients with disseminated histoplasmosis. We report a case of adrenal histoplasmosis in an immune-competent subject presenting with adrenal insufficiency. Case Report: A 49 years old Indian male presented with three months history of weakness, nausea and vomiting, mucocutaneous pigmentation and weight loss. Past medical history was significant for tuberculosis, for which he was incompletely treated. He was non-smoker, non-alcoholic and non-diabetic, with no history of sexual promiscuity. USG of abdomen revealed bilateral suprarenal mass, with right adrenal (48.3x 39.3mm) and left adrenal measuring (42.4 x 38mm). CECT scan of upper abdomen showed enlargement of both adrenal glands with right adrenal 44x25x43mm, left adrenal measuring 53x37x46 mm suggestive of adrenal adenoma. CT guided FNAC of right adrenal mass showed necrosis, many budding yeast cells having the morphology of Histoplasma capsulatum. The patient was treated with liposomal form of amphotericin-B 150 mg / day for two weeks followed by oral itraconazole 200mg BD for one year and hydrocortisone 25 mg/day in divided doses. After one month, there was gain in weight, pigmentation faded and nausea & vomiting disappeared. Conclusion: Adrenal histoplasmosis usually occurs in a setting of immunocompromised condition and in endemic area, but it does occur in immunocompetant hosts from non-endemic area, as in our case. It is prudent to obtain a cytological or histopathological examination to confirm the diagnosis so that appropriate treatment can be instituted to avoid fatal complications.

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Disseminated histoplasmosis in an apparently immunocompetent individual from north India: a case report and review

Kathuria¹,

Capoor

Yadav

et al. 2013

Med Mycol

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Mucocutaneous histoplasmosis is frequently reported in patients with acquired immune deficiency syndrome (AIDS), but it is rare in immunocompetent hosts. Disseminated histoplasmosis involving skin and larynx in a 50-year-old immunocompetent male is described from a non-endemic area in India. The infection appeared to be imported from Thailand. The patient responded very well to intravenous amphotericin B followed by itraconazole. A review of all cases of histoplasmosis occurring in immunocompetent patients from India is reported. Most cases are reported from the Gangetic plains. Adrenals are the most common organ involved in immunocompetent patients, but adrenal insufficiency is not common. Skin lesions and oral ulcers are seen in more than one-third of patients. Predisposing factors like exposure to birds, farming, mining, diabetes were observed in few patients.

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Fine Needle Aspiration Cytology in Bilateral Adrenal Masses in a 58-Year-Old Man

Cited by 4 publications

References 4 publications

Adrenal histoplasmosis: An unusual cause of adrenomegaly

Adrenal histoplasmosis: An unusual cause of adrenomegaly

Adrenal histoplasmosis in an immunocompetant Individual– a rare case report

Disseminated histoplasmosis in an apparently immunocompetent individual from north India: a case report and review

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