Isolated adrenal cryptococcosis, diagnosed by fine‐needle aspiration biopsy: A case report

Cocker, Rubina; McNair, Sean A.; Kahn, Leonard B.; Kwon, Sean; Ding, Xin; Zeltsman, Vadim; Sung, Chris

doi:10.1002/dc.23079

Cited by 6 publications

(4 citation statements)

References 7 publications

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“…These primary adrenal insufficiency symptoms include fatigue, anorexia, hypotension, hyperkalemia, hyponatremia, skin hyperpigmentation, and hypoglycemia, with sudden death also possibly being a presenting symptom [ 17 , 18 , 19 ]. In previous reports [ 5 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ], adrenal gland involvement of cryptococci has been typically associated with disseminated disease, with CNS, or lung infections [ 5 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 30 , 32 , 33 , 36 , 37 ], but several exceptions exist in the literature (for complete list of previous cases with adrenal gland involvement see Table S2 [ 5 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 3...…”

Section: Discussionmentioning

confidence: 99%

“…In previous reports [ 5 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ], adrenal gland involvement of cryptococci has been typically associated with disseminated disease, with CNS, or lung infections [ 5 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 30 , 32 , 33 , 36 , 37 ], but several exceptions exist in the literature (for complete list of previous cases with adrenal gland involvement see Table S2 [ 5 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ])....…”

Section: Discussionmentioning

confidence: 99%

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Diffuse Adrenal Gland and Pancreas Necrosis in a Patient with Disseminated Cryptococcosis—Case Report

Wappler-Guzzetta

Gray

Dagostino

et al. 2022

Life

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(1) Background: Cryptococcus neoformans is mostly known for causing meningitis, with or without disseminated disease. (2) Case presentation: An immunocompromised 75-year-old gentleman presented post renal transplant with generalized weakness, altered mental status, hypoxemia, and hyponatremia, and was found to have disseminated cryptococcal infection. After an initial improvement, the patient became suddenly hypotensive, and passed away soon after. The autopsy revealed widespread cryptococcal involvement, with the most severely affected organs being the brain, lungs, pancreas, adrenal glands, and spleen. The pancreas and one of the adrenal glands revealed diffuse granulomatous cryptococcal infection, with large areas of necrosis. The spleen also showed a large area of cryptococcal necrosis. In addition, the patient had chylous ascites, without histologically identifiable organisms. (3) Conclusions: This is a rare case of disseminated cryptococcal infection with severe necrotizing adrenalitis and pancreatitis, in addition to significant spleen, lung, and central nervous system involvement. The early recognition and treatment of the adrenal gland and pancreas cryptococcosis with surgical interventions may lead to better outcomes in affected patients. Furthermore, steroid treatment and diabetes mellitus may be risk factors for adrenal gland involvement. Additionally, clinicians should keep cryptococcal infection in their differential diagnosis for isolated adrenal gland and pancreas lesions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diffuse Adrenal Gland and Pancreas Necrosis in a Patient with Disseminated Cryptococcosis—Case Report

Wappler-Guzzetta

Gray

Dagostino

et al. 2022

Life

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“…In most of the reports, the enlargement was mentioned [5–8] at the diagnosis or did not change, even after the antifungal treatment was effective [9–14]. There is only one report which shows a decrease in adrenal gland enlargement after treatment with amphotericin B [15]; however, the images obtained after treatment clearly showed adrenal gland enlargement.…”

Section: Discussionmentioning

confidence: 99%

Normalization of Bilateral Adrenal Gland Enlargement after Treatment for Cryptococcosis

Muraoka

Iwama

Arima

2017

Case Reports in Endocrinology

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Cryptococcosis usually occurs in immunocompromised patients and can cause enlargement of the adrenal glands, although the morphologic changes after treatment have not been reported in detail. We report the case of 24-year-old man with fevers, headaches, and impaired consciousness who had been treated with glucocorticoids for a protein-losing gastroenteropathy. The cerebrospinal fluid analysis revealed cryptococcal meningitis. Computed tomography showed bilateral adrenal enlargement. A retrospective analysis revealed that the enlargement had been detected 5 months before admission and gradually increased. The enlargement was improved with antifungal therapy and normalized 6 months later. This is the first report describing morphological changes in the adrenal glands associated with cryptococcal meningitis. Adrenal enlargement by cryptococcosis can be improved without any abnormal findings, including calcifications, which may be a unique characteristic from other diseases, including tuberculosis.

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“…Cryptococcal infections most commonly present as pneumonia or meningitis with adrenal glands only usually involved in immunocompromised patients with disseminated cryptococcal infection [18]. However, cases of isolated adrenal gland involvement have been reported [19]. CT can demonstrate enlarged adrenal glands [20], and diagnosis is confirmed by a biopsy that shows budding yeasts with capsules on smear examination with India ink or methenamine silver stain (Figure 2).…”

Section: Adrenal Cryptococcosismentioning

confidence: 99%

Unusual Presentations of Adrenal Masses

Kumar¹,

Singh²

2017

Clinical Management of Adrenal Tumors

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With the advancement in imaging technology and pathological evaluation, several unusual adrenal gland lesions have been identified over the years. Presently, the literature consists of case reports or small case series without a comprehensive review on these uncommon adrenal pathologies. The current chapter discusses the epidemiology, pathogenesis, pathology, imaging features and management principles of uncommonly reported infectious and neoplastic adrenal masses.

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Isolated adrenal cryptococcosis, diagnosed by fine‐needle aspiration biopsy: A case report

Cited by 6 publications

References 7 publications

Diffuse Adrenal Gland and Pancreas Necrosis in a Patient with Disseminated Cryptococcosis—Case Report

Diffuse Adrenal Gland and Pancreas Necrosis in a Patient with Disseminated Cryptococcosis—Case Report

Normalization of Bilateral Adrenal Gland Enlargement after Treatment for Cryptococcosis

Unusual Presentations of Adrenal Masses

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