A Case of Adrenal Tuberculosis with Atypical Clinical Manifestation

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Kosin Med J. 2013;28(2):183-186

Publication date (electronic) : 2013 January 19

doi : https://doi.org/10.7180/kmj.2013.28.2.183

Moo Hyun Son ¹, Jung Kyu Park ¹, Hyun Sik Hwang ¹, Byung Ho Kim ¹, Eui Dal Jung^,¹, Young Sik Choi ²

¹Department of Internal Medicine, College of Medicine, Catholic University of Daegu, Korea

²Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea

Corresponding author: Eui Dal Jung, Department of internal Medicine, Catholic University of Daegu School of Medicine, 33 gil 17 Duryugongwon-ro, Nam-gu, Daegu, 705-718, Korea TEL: +82-53-650-4026 FAX: +82-53-651-4009 E-mail: jed15@cu.ac.kr

Received 2012 October 04; 2012 October 26; Accepted 2012 October 26.

Abstract

Addison’s disease is a rare disorder that causes fatigue, genral weakness, weight loss, pigmentation due to adrenal hypofunction and it’s underlying causes are various. We report a case of 42-year-old man with fatigue, generalized cutaneous pigmentation. Computed tomography showed bilateral adrenal enlargement, but no calcification. Adrenal tuberculosis was established by ultrasound-guided fine needle aspiration biopsy.

Keywords: Addison’s disease; Adrenal tuberculosis

Fig. 1.

Dynamic adrenal gland computed tomography. Both adrenal gland show nodular hyperplasia and enlargement. (A) pre-enhance phase, (B) arterial phase.

Fig. 2.

Skin punch biopsy. The melanocytes are mildly increased in number (HE stain, × 400).

Fig. 3.

Adrenal gland, Fine needle aspiration biopsy. There is a caseation necrosis which is suspicious of tuberculosis (HE stain, × 400).

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