Use of computed tomography in the detection of adrenal gland involvement in tuberculosis patients.

THESIS: S. Yamashita submitted this dissertation for his Masters in Tropical Diseases at Botucatu School of Medicine, São Paulo State University, UNESP, Botucatu, São Paulo, Brazil, 2001.

Advisor: Professor Jussara Marcondes Machad

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ABSTRACT: The Computed Tomography (CT) is an important method to evaluate tuberculosis patients with suspected adrenal gland involvement. Adrenal gland imaging is important for patients with and without clinical and biochemical evidence of function disturbances in this organ. In this study, CT was used for the evaluation of individuals without (G1) and with tuberculosis (G2). Adrenal antero-posterior dimension, thickness, and length were compared in G1 and G2. Disease duration with morphological alteration in G2, distribution according to sex and age in G1 and G2, and skin color in G1 and G2 were also evaluated. The right adrenal antero-posterior dimensions and thickness were larger in G1 patients. Frequency of males was higher in G2; age limits were higher than in G1; Caucasoid were equally found in both groups. No association was observed between disease duration and morphological alteration in G2. Higher adrenal enlargement was observed in G2. The most important CT findings in tuberculosis patients were enlargement of the adrenal without calcification, enlargement of the adrenal with punctiform calcification, and gland residual calcification. Although morphological information from CT cannot lead to a definitive tuberculosis diagnosis, it may help in suggest primary adrenal insufficiency etiology.

Key words: computed tomography, adrenal gland, tuberculosis, adrenal calcification.

Address to correspondence
S. Yamashita
Departamento de Doenças Tropicais e Diagnóstico por Imagem, Faculdade de Medicina de Botucatu, UNESP
Distrito Rubião Junior, s/n
18618-000, Botucatu, SP, Brasil
crisnog@fmb.unesp.br