Bilateral Adrenal Histoplasmosis Incidentally Detected on 18F- FDG PET/CT Scan in an Immunocompetent Man: A Case Report and Review of Literature

Articles in Press

Document Type : Case report

Authors

1 Department of Nuclear medicine Dr Rajendra Prasad government medical college

2 Department of Oncology a Dr Rajendra Prasad Government medical college Kangra Himachal Pradesh

10.22038/aojnmb.2026.92421.1683

Abstract

Background:Adrenal histoplasmosis is a rare presentation of disseminated fungal infection that can mimic malignancy or granulomatous disease.

Case Presentation: A 51 year old immunocompetent man with no significant past medical history was referred for evaluation of five months of progressive unexplained weight loss (7 kg), anorexia, intermittent low grade fever, and right shoulder pain. An 18F-FDG PET/CT scan showed moderate grade FDG uptake in left suprarenal region with central photopenic area and high grade FDG uptake in right supra renal region and moderate grade FDG uptake at bilateral scapular regions. No additional sites of abnormal uptake were noted. On CT guided biopsy and microscopic examination fungal elements were detected. Oral itraconazole 200 mg twice daily and hydrocortisone replacement therapy were initiated. Clinical and biochemical improvement on follow up at 6 months supported treatment response.

Conclusions: 18F-FDG PET/CT is a valuable imaging modality for incidental detection of adrenal histoplasmosis and for guiding biopsy in metabolically active lesions. Early diagnosis paired with antifungal and corticosteroid therapy optimizes patient outcomes in immunocompetent adults presenting with bilateral adrenal masses.

Keywords

Main Subjects

Asia Oceania Journal of Nuclear Medicine and Biology

Articles in Press, Accepted Manuscript
Available Online from 21 February 2026

Files

Share

How to cite

Statistics