Adrenal histoplasmosis: Diagnosis by fine-needle aspiration biopsy

A 54-year-old man presented with a 6-month history of fever, night sweats, and weight loss. He had hepatosplenomegaly, and bilateral adrenal masses were discovered on computed tomographic (CT) scan. CT-guided fine-needle aspiration biopsy (FNAB) of the right adrenal mass demonstrated purulent material. Special stains done on this material showed organisms with morphologic features of Histoplasma capsulatum. The patient was started on antifungal therapy and discharged. FNAB of the adrenal gland is an effective method in the diagnosis of unusual infectious diseases. Special stains for micro-organisms proved helpful in the initial diagnosis of histoplasmosis.