case_images: PMC4531549_01
case_images: CT of abdomen revealed bilateral adrenal masses with central necrosis.
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case_images: Chest radiographs obtained on admission revealed normal findings, but a CT scan of the abdomen revealed bilateral adrenal masses and hepatosplenomegaly (Figure 1).
case_images: CT-guided adrenal gland biopsy shows numerous epithelioid cells and caseous necrosis consistent with tuberculosis.
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case_images: CT-guided adrenal gland biopsy was done and showed numerous epithelioid cells and caseous necrosis consistent with tuberculosis (Figure 2).
case_images: On bone marrow aspiration, mature histiocyte engulfing hematic cells is seen observed (5.0%).
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case_images: On subsequent bone marrow aspiration and biopsy, hemophagocytic histiocytes had increased in proportion (4.6%) without accompanying evidence of malignancy (Figure 3), hence HPS associated with adrenal gland tuberculosis was diagnosed.