1/18. Coexistence of histoplasma granulomas and Warthin's tumor in the submaxillary salivary gland.A 49-year-old woman had a mass in the left submaxillary salivary gland that histologic examination showed to be a Warthin's tumor. In addition, there were multiple necrotizing and confluent granulomas that stained positive for histoplasma organisms using the Gomori methenamine silver stain. The histoplasma organisms in the lymphoid tissue with Warthin's tumor is an extrapulmonary manifestation of the disease which probably spread from the lungs via the lymphatics. The coexistence of the Warthin's tumor and the granulomas is a rare incidental finding.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/18. histoplasmosis of the thyroid.Fungal infection of the thyroid is rare. Most reported cases have involved aspergillus, coccidioides, and candida species in the setting of disseminated disease. infection of the thyroid with histoplasma capsulatum is rarely reported as part of disseminated disease, even in geographic areas where histoplasmosis is endemic. We report a 52-year-old woman with a previous Hashimoto's disease and non-Hodgkin's lymphoma in which a diffuse enlarged thyroid gland with a large nodule was the only apparent locus of histoplasmosis. Fine-needle aspiration of the thyroid was an important diagnostic tool in establishing the diagnosis of histoplasmosis of the thyroid. The patient was initially treated with itraconazole (400 mg/day) for the fungal infection and six cycles of chemotherapy for the lymphoma. At a 6-month follow-up examination, the patient was doing well on suppressive therapy of itraconazole (200 mg/day), with no symptoms and with regression of the thyroid nodule and cervical adenopathy.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
3/18. histoplasma capsulatum in adrenal gland aspirate--a case report.We report a case of disseminated histoplasmosis in a 60-year-old non-immunocompromised patient who presented to us with fever and hepatosplenomegaly. Sonographic & CT examination of the abdomen showed bilateral adrenal masses. Cytological examination of the aspirated material from the mass showed yeast forms of H. capsulatum.- - - - - - - - - - ranking = 0.8keywords = gland (Clic here for more details about this article) |
4/18. A case of histoplasma capsulatum causing granulomatous liver disease and Addisonian crisis.A 56-year-old man with persistently elevated liver enzyme levels, fatigue, lethargy and a 9.0 kg weight loss over six months underwent a percutaneous liver biopsy that demonstrated multiple granulomas. Screening serologies were positive for histoplasmosis, and he was started on itraconazole treatment. He returned to hospital the same night with coffee-ground emesis and in Addisonian crisis requiring parenteral steroids and intensive care unit support. An abdominal computed tomography scan revealed bilaterally enlarged, nonenhancing adrenal glands suggestive of infarcts, presumed secondary to histoplasmosis. Treatment was initiated with amphotericin b, and histoplasma capsulatum was cultured from his urine and cerebrospinal fluid. A serum immunodiffusion test was also positive for both H and M bands, indicating active infection with histoplasmosis species. His serum and urine samples were also weakly positive for the antigen. Despite complications of renal failure, pneumonia and congestive heart failure, he recovered with medical therapy and was discharged home to complete a prolonged course of itraconazole therapy. While hepatic granulomas often reflect an occult disease process, the cause may remain undiscovered in 30% to 50% of patients despite exhaustive investigations. H capsulatum is an uncommon cause of granulomatous liver disease, and with its protean clinical presentation, a high index of suspicion is needed to make the diagnosis and avoid the potentially high fatality rate associated with disseminated infection.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
5/18. Chronic disseminated histoplasmosis in an apparently immuno-competent Belgian patient.A 77 year-old Belgian man was admitted for weight loss and elevated liver enzymes. He used to live in Central africa until 1986 and denied any travel outside belgium during the last decade. physical examination was unremarkable except for a lip ulceration. blood tests showed increases of liver enzymes and CEA. In the search of an abdominal cancer, CT showed a normal liver but enlarged surrenal glands, while colonoscopy disclosed multiple mucosal lesions. colic and lip biopsies identified histoplasma capsulatum var capsulatum. hiv serology was negative. lymphocyte count was normal but lymphocyte function was depressed. The patient dramatically improved under oral treatment with itraconazole 400 mg daily for six months. This case indicates that chronic disseminated histoplasmosis can reactivate in a healthy and apparently non-immunocompromised person living in europe.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
6/18. Imaging spectrum in disseminated histoplasmosis: case report and brief review.The clinical manifestations of chronic disseminated histoplasmosis are non-specific and resemble those of other chronic infections and malignancies. We report the radiographic, sonographic and contrast-enhanced CT appearances of histoplasmosis in an adult male with non-insulin dependent diabetes mellitus, who was hiv negative and presented with weight loss and pyrexia. Imaging studies simulated tuberculosis with mediastinal lymphadenopathy, bilateral fibrotic lung lesions, hepatomegaly and bilateral hypoattenuating adrenal enlargement, without clinical or laboratory evidence of hypoadrenalism. Computed tomography-guided fine-needle aspiration biopsy of adrenal glands revealed histoplasma capsulatum. We report our experience to increase awareness of the imaging spectrum of disseminated histoplasmosis and its similarity to tuberculosis as, with increasing incidence of AIDS, the chances of these infections are likely to increase. Moreover, awareness of this entity is important because it is known that untreated disseminated histoplasmosis is fatal.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
7/18. histoplasmosis of the central nervous system.histoplasma capsulatum infection of the central nervous system is extremely rare in the United Kingdom partly because the organism is not endemic. However, because the organism can remain quiescent in the lungs or the adrenal glands for over 40 years before dissemination, it increasingly needs to be considered in unexplained neurological disease particularly in people who lived in endemic areas as children. In this paper a rapidly progressive fatal myelopathy in an English man brought up in india was shown at necropsy to be due to histoplasmosis. The neurological features of this infection are reviewed.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
8/18. Adrenal histoplasmosis in Cushing's syndrome with bilateral adrenocortical nodular hyperplasia.Adrenal histoplasmosis in Cushing's syndrome of adrenal origin is rare. A patient with Cushing's disease with bilateral nodular hyperplasia and histoplasmosis of both the adrenal glands is described. The diagnosis of histoplasmosis was only made post operatively as the constitutional manifestations, besides being partially masked by hypercortisolism also resemble those of tuberculosis.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
9/18. Disseminated histoplasmosis. Typical presentation with involvement of the adrenal glands.A 67-yr-old Indonesian patient with disseminated histoplasmosis is described. He had general malaise and fever for 6 months; an oral ulcer, bilateral adrenal gland enlargement and partial adrenal insufficiency were found. An adrenal aspirate contained histoplasma capsulatum. The literature on adrenal involvement in disseminated histoplasmosis is reviewed and it is concluded that bilateral enlargement, demonstrated by sonography or computed tomography, in a patient with general malaise is an important clue to the diagnosis.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
10/18. Disseminated histoplasmosis diagnosed by fine needle aspiration biopsy of the adrenal gland. A case report.A case of disseminated histoplasmosis diagnosed by fine needle aspiration (FNA) biopsy of the adrenal gland is reported for a 60-year-old man who presented with a 40-pound weight loss and abdominal computed tomography showing bilateral adrenal enlargement. FNA biopsy of the adrenal gland revealed clusters of macrophages with abundant cytoplasm containing the yeast forms of histoplasma capsulatum. This case emphasizes that FNA is effective in diagnosing infectious as well as neoplastic conditions of the adrenal glands.- - - - - - - - - - ranking = 1.4keywords = gland (Clic here for more details about this article) |
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