Histoplasmosis of the adrenal glands studied by CT.

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Abstract
Computed tomography (CT) of the adrenal glands was performed on 7 patients who had histologically proved disseminated histoplasmosis. All 7 patients showed some degree of adrenal gland abnormality. The range of CT findings included minimal enlargement with faint flecks of Ca, moderate enlargement with focal low attenuation nodules and massive enlargement with large areas of necrosis or dense calcification. The changes in each patient were bilateral and symmetrical. Adrenal gland shape was usually preserved. Findings of percutaneous adrenal biopsy, which was performed under CT guidance, made the diagnosis in 1 patient. Of 7 patients, 5 had adrenal insufficiency. Thus, the diagnosis of disseminated histoplasmosis should be considered in any patient who has bilateral adrenal gland enlargement and who resides in an endemic area, especially if there is evidence of adrenal insufficiency; CT is superb for the assessment of adrenal gland morphology in this disease; CT-directed biopsy is the recommended method of confirming the diagnosis in difficult cases.

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