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

Ahuja, Arvind; Mathur, Sandeep; Iyer, V. K.; Sharma, Surendra Kumar; Kumar, Naveen; Agarwal, Shipra

doi:10.1002/dc.21660

Cited by 12 publications

(14 citation statements)

References 6 publications

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“…To the best of our knowledge, relatively few recent reports (the majority of which contained very limited numbers of patients) have highlighted the cytomorphological findings of histoplasmosis . Many patients described in these studies were immunosuppressed with HIV.…”

Section: Introductionmentioning

confidence: 99%

Fine‐needle aspiration of histoplasmosis in the era of endoscopic ultrasound and endobronchial ultrasound

Gailey

Klutts

Jensen

2013

Cancer Cytopathology

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BACKGROUND: Histoplasmosis has a textbook cytologic description with numerous intracellular organisms that are readily apparent on routine stains. This is based on series and reports describing histoplasmosis in immunosuppressed patients with disseminated disease. With the advent of ultrasound-guided (US) fine-needle aspiration (FNA) techniques, a marked increase in the cytologic diagnosis of histoplasmosis in immunocompetent patients is noted. METHODS: A search identified all cytology cases diagnosed with Histoplasma within the past 10 years. Cases were reviewed, along with patient demographic, clinical, and laboratory data. RESULTS: A total of 40 FNA cases of histoplasmosis were identified. Patients ranged in age from 15 years to 86 years. There were 23 female patients and 17 male patients; 37 were immunocompetent and 3 were immunosuppressed. Sixteen patients were being staged for primary tumors of other sites; others presented with primary pulmonary symptoms or histoplasmosis was noted incidentally. Specimens were composed of bland acellular necrosis, most commonly with granulomas (77.5%); only rare intracellular organisms were present on routine stains, and variable extracellular organisms were noted on Grocott methenamine silver stain (GMS) stain. GMS stain on direct smears was found to be more sensitive than cell block. Laboratory studies for urine antigen, yeast, and mycelial antibody (by compliment fixation), serum antibody (by immunodiffusion), and culture were positive in 11.8%, 59.1%, 4.5%, 47.6%, and 3.4% of cases, respectively. CONCLUSIONS: In an endemic region, histoplasmosis presents more commonly in immunocompetent patients as localized fibrocaseous disease on FNA and is often identified by high-resolution imaging. FNA is increasingly used in the diagnosis because of endoscopic ultrasound and endobronchial ultrasound. GMS stain on direct smears is more sensitive than cell block. In general, laboratory tests have low sensitivity in this patient population. Cancer (Cancer Cytopathol) 2013;121:508-17.

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Section: Introductionmentioning

confidence: 99%

Fine‐needle aspiration of histoplasmosis in the era of endoscopic ultrasound and endobronchial ultrasound

Gailey

Klutts

Jensen

2013

Cancer Cytopathology

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“…1 For moderate to severe disseminated infections, the Infectious Disease Society of America recommends liposomal amphotericin B followed by itraconazole, although itraconazole therapy alone is often sufficient for milder cases. 1,10 In spite of high cost, our patient managed to get the total 18 doses of Inj. Liposomal Ampoterecin B at a dose of 1 mg/kg/day followed by oral Itraconazole 200 mg/day with a plan to continue for 18 months.…”

Section: Discussionmentioning

confidence: 91%

A Case of Adrenal Histoplasmosis

et al. 2017

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“…The patient in this study was a 46-year-old-diabetic male and a resident of Delhi in North India. Delhi has previously not been considered endemic but some cases have been reported recently [12][13][14]. Disseminated histoplasmosis develops mostly in patients who are immunocompromised.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Histoplasmosis and Role of Direct Microscopy-A Case Report

Malhotra¹,

Dhundial²,

Njk³

et al. 2017

Clin Microbiol

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Histoplasmosis is an important systemic fungal infection in endemic areas. It has been reported from various states of India, with particular endemicity in north-eastern regions. Most infections are asymptomatic or self-limited, some individuals develop acute pulmonary infections or severe and progressive disseminated infection. Primary infection occurs in lungs and can also involve skin, lymph nodes, GIT, CNS, adrenals, liver and spleen. The particular interest of this paper is to present a case of disseminated histoplasmosis in diabetic patient and to demonstrate the importance of direct KOH mount preparation for diagnosis of such cases.

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

Cited by 12 publications

References 6 publications

Fine‐needle aspiration of histoplasmosis in the era of endoscopic ultrasound and endobronchial ultrasound

Fine‐needle aspiration of histoplasmosis in the era of endoscopic ultrasound and endobronchial ultrasound

A Case of Adrenal Histoplasmosis

Cutaneous Histoplasmosis and Role of Direct Microscopy-A Case Report

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