Diagnosis of disseminated histoplasmosis by fine needle aspiration of the adrenal gland.

The cytologic findings in a case of disseminated histoplasmosis diagnosed by fine needle aspiration (FNA) of the adrenal gland are presented. Bilateral adrenal enlargement was discovered on CT scan in a patient whose systemic symptoms had been attributed to tuberculosis, but were resistant to antituberculous chemotherapy. The aspirate contained numerous histiocytes containing intracytoplasmic organisms with the morphologic features of Histoplasma capsulatum. The case shows that radiographically directed FNA of the adrenal gland, which has been recognized as a valuable aid in the confirmation of primary and secondary neoplasia, may also be quite useful in the less common setting of infectious disease involving this organ.