RESUMO
Involvement of the thyroid gland with tuberculosis (TB) is unusual and is commonly associated with hypothyroidism. Involvement of the thyroid as a part of disseminated TB is even rarer. Dissemination is an indication of immunosuppression. We present a 16-year-old immunocompetent girl with disseminated TB involving the thyroid gland and the right radius bone with features of hyperthyroidism. The patient responded well to anti-TB treatment.
Assuntos
Hipertireoidismo/diagnóstico , Rádio (Anatomia)/diagnóstico por imagem , Doenças da Glândula Tireoide/diagnóstico por imagem , Tuberculose Endócrina/diagnóstico por imagem , Tuberculose Osteoarticular/diagnóstico por imagem , Adolescente , Antituberculosos/uso terapêutico , Biópsia por Agulha Fina , Feminino , Humanos , Hipertireoidismo/sangue , Hipertireoidismo/etiologia , Imunocompetência , Imageamento por Ressonância Magnética , Radiografia , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/tratamento farmacológico , Doenças da Glândula Tireoide/patologia , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue , Tuberculose Endócrina/complicações , Tuberculose Endócrina/tratamento farmacológico , Tuberculose Endócrina/patologia , Tuberculose Osteoarticular/complicações , Tuberculose Osteoarticular/tratamento farmacológico , UltrassonografiaRESUMO
Computed tomography (CT) performed for a 75-year-old man as a follow-up examination for deep vein thrombosis in October 2010 revealed a left adrenal mass (diameter, 8 mm). In December 2012, the adrenal mass increased to 28 mm in diameter, and he was referred to our department. Several blood examinations revealed that the adrenal mass was non-functioning, and only peripheral lesions were observed to be enhanced by using CT in the arterial phase. Malignancy was suspected due to the irregular shape and growth of the mass, and left adrenalectomy was performed in February 2013. The histopathological diagnosis was adrenal mycobacteriosis, and clinical diagnosis was adrenal tuberculosis. No other tuberculosis infection-related lesion was detected, and the patient was treated with multidrug antituberculous chemotherapy.
Assuntos
Doenças das Glândulas Suprarrenais/patologia , Tuberculose Endócrina/patologia , Doenças das Glândulas Suprarrenais/tratamento farmacológico , Idoso , Humanos , Masculino , Tuberculose Endócrina/tratamento farmacológicoRESUMO
BACKGROUND: Tuberculosis is a rare cause of granulomatous thyroiditis, whose diagnosis may be difficult with routine cytopathology and staining for acid-fast bacilli (AFB). STUDY DESIGN: Amongst 7962 cases of various thyroid lesions subjected to fine needle aspiration cytology (FNAC) over a period of 12 years, 34 cases (0.43%) were found to have cytological features of granulomatous inflammation with or without necrosis, which could be due to tuberculosis, granulomatous thyroiditis or other causes of granulomatous inflammation such as sarcoidosis or fungal infections. DNA was extracted from the material available on May-Grünwald-Giemsa-stained smears from the archival material. PCR for Mycobacterium tuberculosis was performed for insertion sequence IS6110. RESULTS: The age of the patients ranged from 32 to 58 years (median 48 years); 24 were female and 10 male. FNAC from thyroid swellings showed epithelioid granulomas with giant cells and/or necrosis. Although acid-fast bacilli were only seen in smears in two cases, 19/34 (55.9%) showed the presence of 123 bp DNA band under ultraviolet transillumination. Five control cases were negative. CONCLUSION: Our study of archival cytological material illustrates the importance of PCR as a potentially useful tool for the detection of M. tuberculosis DNA from FNAC of thyroid lesions, which could provide an alternative for rapid diagnosis of thyroid tuberculosis in AFB-negative cases.
Assuntos
Reação em Cadeia da Polimerase/métodos , Doenças da Glândula Tireoide/microbiologia , Doenças da Glândula Tireoide/patologia , Tuberculose Endócrina/microbiologia , Tuberculose Endócrina/patologia , Adulto , Biópsia por Agulha Fina/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Tireoidite Subaguda/patologiaRESUMO
Tuberculosis (TB) of the thyroid gland is extremely rare with fewer than 200 cases reported worldwide. We report a case of primary TB of the thyroid in a 73-year-old gentleman with no risk factors for TB, presenting with a painless right neck mass of one week's duration. A pre-operative ultrasound scan reported a solid-cystic, right TIRADS 5 nodule, and initial fine needle cytology showed granulomatous inflammation and was negative for AFB on Ziehl-Neelsen stain. A right hemithyroidectomy was done subsequently, and histology demonstrated necrotizing granulomatous inflammation, but TB-PCR detected Mycobacterium DNA. Primary TB of the thyroid is rare and can manifest in patients with no apparent risk factors for TB. Initial cytology may only yield granulomatous inflammation and surgery is needed to ascertain the exact cause of granulomatous inflammation and additional TB-PCR can help clinch the diagnosis.
Assuntos
Doenças da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/diagnóstico , Tuberculose Endócrina/diagnóstico , Idoso , Biópsia por Agulha Fina , Diagnóstico Diferencial , Humanos , Masculino , Reação em Cadeia da Polimerase , Doenças da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/patologia , Tireoidectomia , Tuberculose Endócrina/patologia , UltrassonografiaRESUMO
Tuberculosis of the thyroid gland is a very rare condition. A case of a 47-year-old female with a history of a euthyroid multi-nodular goitre is presented. The patient developed hoarseness due to right recurrent laryngeal nerve paralysis, confirmed with indirect laryngoscopy. On repeated ultrasound, volumetric progression of a dominant nodule in the inferior part of the right thyroid lobe was noticed. Fine needle aspiration was inconclusive. Diagnosis was ultimately based on histopathology of the surgical resection specimen.
Assuntos
Tuberculose Endócrina/diagnóstico , Antituberculosos/administração & dosagem , Biópsia por Agulha Fina , Comorbidade , Quimioterapia Combinada , Feminino , Bócio Nodular/epidemiologia , Humanos , Pessoa de Meia-Idade , Necrose , Doenças da Glândula Tireoide/microbiologia , Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/microbiologia , Tuberculose Endócrina/tratamento farmacológico , Tuberculose Endócrina/epidemiologia , Tuberculose Endócrina/patologiaRESUMO
Primary pituitary tubercular abscess is a very rare disease. It may present clinically with visual loss, headache, seizure, hormonal abnormalities or with cranial nerve palsies. MRI is the diagnostic modality and shows a cystic-solid mass in the sellar and suprasellar region, isointense on T1 and T2W images with heterogeneous areas and ring enhancement on contrast. Surgery remains the initial treatment and it is approached through the trans-sphenoidal/trans-nasal or transcranial route followed by anti-tubercular therapy. We report a case of primary pituitary tubercular abscess managed successfully with a brief review of its pathology. Keywords: abscess; pituitary gland; pyogenic; sella; tuberculosis.
Assuntos
Abscesso Encefálico/diagnóstico , Doenças da Hipófise/diagnóstico , Tuberculose Endócrina/diagnóstico , Adulto , Antituberculosos/administração & dosagem , Abscesso Encefálico/patologia , Abscesso Encefálico/terapia , Feminino , Humanos , Imageamento por Ressonância Magnética , Doenças da Hipófise/patologia , Doenças da Hipófise/terapia , Tuberculose do Sistema Nervoso Central/diagnóstico , Tuberculose do Sistema Nervoso Central/patologia , Tuberculose do Sistema Nervoso Central/terapia , Tuberculose Endócrina/patologia , Tuberculose Endócrina/terapiaRESUMO
Inflammatory lesions of the hypophysis account for 0.5% of all symptomatic diseases of the pituitary, which include lymphocytic hypophysitis, granulomatous hypophysitis with or without specific etiology and pituitary abscess. Sellar tuberculoma is a rare type of granulomatous hypophysitis. We document a case of a postmenopausal lady who presented with galactorrhea, headache and blurring of vision. Based on preliminary investigations, a clinical diagnosis of pituitary adenoma was made and the pituitary gland was surgically excised. Histopathological examination showed caseating granulomas, along with normal areas of preserved pituitary gland and a final diagnosis of tuberculous hypophysitis was made. This case is being documented due to the extremely rare involvement of the pituitary gland by granulomatous lesions such as tuberculosis and to emphasize the role of intraoperative consultation to obviate the need for radical surgery in such lesions.
Assuntos
Adenoma/diagnóstico , Doenças da Hipófise/diagnóstico , Neoplasias Hipofisárias/diagnóstico , Tuberculose Endócrina/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Doenças da Hipófise/patologia , Sela Túrcica/patologia , Tuberculoma/diagnóstico , Tuberculoma/patologia , Tuberculose Endócrina/patologiaRESUMO
Our study aimed to describe the epidemiological, clinical and histological aspects of mammary tuberculosis in Togo. This is a descriptive cross-sectional study of breast tuberculosis for which the diagnosis was presumed on histological grounds in the pathology department (LAP) of the Lomé Tokoin university hospital from January 1995 to December 2016 (20 years). A total of 28 presumed cases of mammary tuberculosis were identified. There were 26 women and 2 men, with an average age of 34.2 ± 0.3 years. The clinical signs were nodule (84.1%), tumefaction (75%), abscess (63.6%) and tumefaction with cutaneous fistulization (59.1%). Breast involvement was isolated in 31.8% of cases and associated with pleuropulmonary tuberculosis in 54.5% of cases. Co-infection with HIV was found in 63.9 % of cases. Histology showed inflammatory granulomas made of Langhans giant cells, epithelioid cells and lymphocytes around the foci of caseous necrosis. Thoracic radiography was abnormal in 16 patients (57.1%).Mammary tuberculosis is not rare in our country. Clinical presentation is often misleading and is a diagnostic challenge, more particularly with breast abscess or cancer.
Assuntos
Doenças Mamárias/patologia , Tuberculose Endócrina/patologia , Adolescente , Adulto , Idoso , Doenças Mamárias/epidemiologia , Doenças Mamárias/microbiologia , Criança , Estudos Transversais , Diagnóstico Diferencial , Feminino , Granuloma/epidemiologia , Granuloma/microbiologia , Granuloma/patologia , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Togo/epidemiologia , Tuberculose Endócrina/epidemiologia , Adulto JovemRESUMO
Tuberculosis affecting the thyroid gland is a rare condition. We present the case of a 30-year-old man with thyroid tuberculosis whose presenting complaints were dyspnoea and hoarseness. There was a cystic mass in the posterosuperior right thyroid lobe extending into the paraglottic space. There was also recurrent laryngeal nerve involvement. We performed surgery and administered post-operative antituberculous treatment.
Assuntos
Doenças da Glândula Tireoide/patologia , Tuberculose Endócrina/patologia , Abscesso/etiologia , Abscesso/patologia , Adulto , Dispneia/etiologia , Rouquidão/etiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Nervo Laríngeo Recorrente/patologia , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/terapia , Tuberculose Endócrina/complicações , Tuberculose Endócrina/terapia , Paralisia das Pregas Vocais/etiologiaRESUMO
A 21-year-old man from Somalia presented with a painful mass in the thyroid, 6 months offatigue, weight loss and fever. Two separate courses of antibiotics did not improve his condition. Thyroid function tests were normal. The chest X-ray showed an enlarged hilus with some pulmonary infiltration around it. The diagnosis ofthyroid tuberculosis was established by cytological, microbiological and PCR testing of a fine needle aspirate of a thyroid lymph node. Treatment with antituberculosis agents resulted in a complete clinical response. The differential diagnosis of a painful thyroid mass encompasses subacute granulomatous thyroiditis, infectious thyroiditis, radiation- or trauma-induced thyroiditis and haemorrhage in the thyroid lymph nodes. Although thyroid tuberculosis is mainly a disease of developing countries, increasing immigration can lead to a higher incidence of this rare form of extrapulmonary tuberculosis and should therefore also be considered in patients with a painful thyroid mass.
Assuntos
Antituberculosos/uso terapêutico , Doenças da Glândula Tireoide/diagnóstico , Tuberculose Endócrina/diagnóstico , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Mycobacterium tuberculosis/isolamento & purificação , Somália , Doenças da Glândula Tireoide/tratamento farmacológico , Doenças da Glândula Tireoide/microbiologia , Doenças da Glândula Tireoide/patologia , Resultado do Tratamento , Tuberculose Endócrina/tratamento farmacológico , Tuberculose Endócrina/patologiaRESUMO
OBJECTIVES: The aims of this study were to emphasize the difficulties of diagnosing thyroid tuberculosis because of its non specific symptoms and to encourage physicians to seek it more frequently. MATERIAL AND METHODS: Six cases of thyroid tuberculosis diagnosed within a 3-year period were included in a retrospective study. RESULTS: There were two men and four women, mean age 45 years. Four patients underwent lobo-isthmectomy with frozen section analysis which enabled us to rectify the diagnosis. Medical treatment was based on a 6-month course of bactericidal chemotherapy. Outcome was favorable in all the cases with 17 months average follow up. CONCLUSION: Symptoms of thyroid tuberculosis are misleading, pathologic findings are of increasing importance for diagnosis, which with the new serology techniques may improve further.
Assuntos
Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/microbiologia , Tuberculose Endócrina/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Antituberculosos/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Doenças da Glândula Tireoide/patologia , Doenças da Glândula Tireoide/terapia , Tireoidectomia/métodos , Resultado do Tratamento , Tuberculose Endócrina/patologia , Tuberculose Endócrina/terapiaAssuntos
Bócio Nodular/diagnóstico , Tuberculoma/diagnóstico , Tuberculose Endócrina/diagnóstico , Antituberculosos/uso terapêutico , Terapia Combinada , Feminino , Bócio Nodular/tratamento farmacológico , Bócio Nodular/patologia , Bócio Nodular/cirurgia , Terapia de Reposição Hormonal , Humanos , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Tireoidectomia , Tiroxina/uso terapêutico , Tuberculoma/tratamento farmacológico , Tuberculoma/patologia , Tuberculoma/cirurgia , Tuberculose Endócrina/tratamento farmacológico , Tuberculose Endócrina/patologia , Tuberculose Endócrina/cirurgia , Tuberculose dos Linfonodos/diagnóstico , Tuberculose dos Linfonodos/microbiologia , Tuberculose dos Linfonodos/cirurgiaRESUMO
1. The clinical and pathologic findings in 100 patients with late generalized tuberculosis (LGT) are described and a comparison made between the findings occurring in the preantibiotic era with those in the early antibiotic period. The clinical presentation of LGT as seen in a general hospital has changed. Whereas, in the preantibiotic era, LGT was often the primary disease, occurring principally in young adults and frequently associated with pulmonary symptoms, in the antibiotic era, LGT commonly occurred together with and was frequently obscured by other diseases, often afflicted the elderly and was much less frequently accompanied by pulmonary symptoms. Symptoms related to extrapulmonary organ tuberculosis in this era were absent in 30% of patients. 2. Diagnostic difficulties in LGT arose because 20% of patients exhibited no constitutional symptoms prior to hospitalization, a history of tuberculosis often was lacking, fever curves and hematologic findings, with the exception of a left shift, commonly were non-specific, monocytosis frequently was absent, chest x-rays were non-diagnostic in about 50% of the cases, and anergy occured particularly in the elderly. 3. Caseous foci responsible for hematogenous spread generally derived from reactivated old caseous lesions located principally in the lungs, lymph nodes, bone, central nervous system, adrenals, and genito-urinary tract. Simultaneous reactivation of anatomically unrelated foci in multiple organs and lymph nodes occurred in 54% of cases. Although chronic pulmonary tuberculosis commonly was associated with LGT in the preantibiotic era, this association was uncommon in recent times. Chronic pulmonary tuberculosis served as the sole source for hematogenous dissemination infrequently and the pulmonary lesions responsible were acute. 5. Large caseous foci located in lymph nodes, bone, prostate gland, and central nervous system frequently occurred in the absence of clinical symptoms and therefore were undiagnosable. 6. The clinical course of LGT was often rapid, although histologic features indicated that the course in some patients was protracted or even episodic. 7. Miliary tubercles very frequently showed caseation and often they enlarged to cause progressive or complicated lesions. Chest x-rays and culture diagnoses were dependent on the formation of these complicated lesions. 8. Liver biopsy is recommended as a diagnostic procedure since 97% of patients exhibited granulomata in this organ. Of diagnostic importance is the fact that 90% of these granulomata exhibited caseous necrosis. Twenty-two percent of patients with liver granulomatas did not show tubercles in the bone marrow. 9. Multiple pathways rather than an exlcusive lymphangitic route were available for tubercle bacilli to gain access to the blood stream and cause hematogenous dissemination.
Assuntos
Tuberculose/diagnóstico , Adolescente , Doenças das Glândulas Suprarrenais/patologia , Adulto , Idoso , Autopsia , Feminino , Humanos , Masculino , Maryland , Pessoa de Meia-Idade , Fatores de Tempo , Tuberculose/epidemiologia , Tuberculose/etiologia , Tuberculose Cardiovascular/patologia , Tuberculose Endócrina/patologia , Tuberculose dos Linfonodos/patologia , Tuberculose Meníngea/patologia , Tuberculose Miliar/patologia , Tuberculose Osteoarticular/patologia , Tuberculose Pulmonar/patologia , Tuberculose Urogenital/patologiaRESUMO
A 67-year-old woman was admitted to the hospital because of intermittent pain in the upper left quadrant of the abdomen. Ultrasound and computed tomography (CT) scan revealed a mass in the body of the pancreas, and angiography demonstrated encasement of the celiac trunk and splenic vein thrombosis. She was thought to have a pancreatic carcinoma and was surgically explored to obtain tissue for diagnosis. A hard and irregular tumor was found, and biopsies revealed granulomatous inflammation with caseous necrosis. The final diagnosis was tuberculosis, and treatment with rifampicin, isoniazid, and ethambutol was undertaken. One year later the patient is asymptomatic and new CT scan shows disappearance of the pancreatic mass.
Assuntos
Pancreatopatias/patologia , Tuberculose Endócrina/patologia , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Pâncreas/diagnóstico por imagem , Pâncreas/patologia , Pancreatopatias/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/patologia , Tomografia Computadorizada por Raios X , Tuberculose Endócrina/diagnóstico , UltrassonografiaRESUMO
We report on three cases with rapidly increasing thyroid masses who were referred with the provisional diagnosis of thyroid carcinoma. In the two cases, the diagnosis of tuberculosis was established after thyroidectomy, but in the third case diagnosis was made pre-operatively with acid fast bacilli (AFB) staining and culture from fine needle aspiration (FNA) material. Although rare, tuberculosis of the thyroid gland should be included in the differential diagnosis of thyroid masses. FNA, AFB staining and culture of the aspirate are important diagnostic tools in these cases.
Assuntos
Doenças da Glândula Tireoide/microbiologia , Doenças da Glândula Tireoide/patologia , Tuberculose Endócrina/patologia , Antituberculosos/uso terapêutico , Biópsia por Agulha , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tuberculose Endócrina/tratamento farmacológicoRESUMO
A 36-year-old female presented with generalized bone pain, muscular weakness and enlarged cervical lymph nodes. The biochemical findings and skeletal survey was suggestive of primary hyperparathyroidism (PHPT). CT of neck and thorax showed enlarged multiple lymph nodes in the cervical and superior mediastinal region. With a diagnosis of PHPT she underwent cervical exploration and excision of enlarged right inferior parathyroid gland along with biopsy of nodes were done. Histopathology revealed the features of right parathyroid adenoma with few foci of epithelioid granuloma and granulomatous lymphadenitis. AFB smear and culture sensitivity was negative. A positive PCR for Mycobacterium tuberculosis of the homogenates of parathyroid tumor confirmed tuberculous inflammation within the parathyroid adenoma. To the best of our knowledge this is the first reported case of parathyroid adenoma associated with tuberculous pathology in a case of PHPT.
Assuntos
Adenoma/patologia , Granuloma/patologia , Hiperparatireoidismo/patologia , Mycobacterium tuberculosis/isolamento & purificação , Neoplasias das Paratireoides/patologia , Tuberculose Endócrina/patologia , Adenoma/complicações , Adenoma/microbiologia , Adulto , DNA Bacteriano/análise , Diagnóstico Diferencial , Feminino , Granuloma/complicações , Humanos , Hiperparatireoidismo/etiologia , Mycobacterium tuberculosis/genética , Neoplasias das Paratireoides/complicações , Neoplasias das Paratireoides/microbiologia , Paratireoidectomia , Reação em Cadeia da Polimerase , Tuberculose Endócrina/complicaçõesRESUMO
OBJECTIVES: To raise awareness of hypercalcemia as a rare and at times inaugural manifestation of adrenal insufficiency. CASE REPORT: Evaluation of hypercalcemia in a 43-year-old man showed adrenal insufficiency. Biopsies of the testes and adrenal glands revealed epithelioid and giant cell lesions indicating tuberculosis. Although tuberculosis can contribute to hypercalcemia, this possibility was ruled out in our patient by the low serum 1,25-dihydroxy-vitamin D3 levels and return to normal of serum calcium and renal function under hormone replacement therapy. It should be noted, however, that a course of pamidronate was given. CONCLUSION: The mechanism of hypercalcemia associated with adrenal insufficiency is controversial. Hyperparathyroidism was ruled out in our patient. Adrenal insufficiency should be considered in some patients with hypercalcemia.
Assuntos
Insuficiência Adrenal/patologia , Hipercalcemia/patologia , Tuberculose Endócrina/patologia , Insuficiência Adrenal/sangue , Insuficiência Adrenal/complicações , Adulto , Antituberculosos/uso terapêutico , Calcitriol/sangue , Quimioterapia Combinada , Fludrocortisona/uso terapêutico , Terapia de Reposição Hormonal , Humanos , Hidrocortisona/uso terapêutico , Hipercalcemia/sangue , Hipercalcemia/etiologia , Masculino , Resultado do Tratamento , Tuberculose Endócrina/complicações , Tuberculose Endócrina/etiologiaAssuntos
Biópsia por Agulha Fina , Corantes , Coloração e Rotulagem/métodos , Nódulo da Glândula Tireoide/patologia , Tuberculose Endócrina/patologia , Tuberculose Pulmonar/patologia , Adulto , Biópsia por Agulha Fina/métodos , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Nódulo da Glândula Tireoide/microbiologia , Tuberculose Endócrina/microbiologia , Tuberculose Pulmonar/microbiologia , Ultrassonografia de IntervençãoRESUMO
Tubercular adrenalitis presents with adrenal enlargement prior to its atrophy and calcification. Imaging modalities like ultrasound, computerized tomography (CT), and magnetic resonance imaging have depicted adrenal enlargement due to various causes. Presented is a clinical-cum-CT review of 14 cases of tubercular adrenal enlargement with addition of five new cases and their CT follow-up.
Assuntos
Doença de Addison/diagnóstico , Doenças das Glândulas Suprarrenais/diagnóstico , Tomografia Computadorizada por Raios X , Tuberculose Endócrina/diagnóstico , Doença de Addison/patologia , Doenças das Glândulas Suprarrenais/patologia , Glândulas Suprarrenais/patologia , Biópsia por Agulha , Humanos , Microscopia Eletrônica de Varredura , Tuberculose Endócrina/patologiaRESUMO
One of the major causes of chronic adrenal insufficiency (Addison's disease) is tuberculous adrenalopathy. Since sonography and computed tomography have become generally available in recent years and are of potential help in the diagnosis of this disease the merits of these methods are discussed in the light of 2 cases of adrenal tuberculosis, followed by a review of the literature. Adrenal calcification is the most significant, although not specific sign of adrenal insufficiency due to tuberculosis. Computed tomography has proven to be the method of choice in the non-invasive diagnosis of tuberculous adrenalopathy and in the monitoring of tuberculostatic treatment in this disease. Sonography is helpful as a preliminary investigation.