The CT scan images show bilateral adrenal disease with necrotic areas and areas of calcification. While bilateral adrenal disease may occur with lymphoma and metastases as well, the presence of calcification and necrotic areas is more suggestive of granulomatous disease. It is usually not possible to differentiate histoplasmosis from tuberculosis and hence the biopsy was performed.
In a tuberculous endemic country like India, this is the most likely possibility.
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