maging Findings of Macronodular Adrenal Hyperplasia

A 67-year-old female presented with complaints of pain and difficulty while walking for three days. There was no history of trauma, fever, chest pain, cough, breathlessness, abdominal pain, nausea or vomiting. Family history and personal history were unremarkable. On examination, the patient was conscious and oriented. No pallor, icterus, cyanosis, clubbing or significant lymph node enlargement was noted. Vitals: temperature: afebrile, Pulse rate: 70/min, Blood Pressure (BP): 140/80 mmHg, and SpO2 of 98% on room air. Systemic examination was regular. On local examination, diffuse non-pitting oedema was present extending from the left foot to the knee joint. Calf tenderness, erythema and local rise of temperature of left lower limb was present. Laboratory investigations revealed a haemoglobin value of 10.6 g/dL and a total leukocyte count of 10,400/cu.mm, (neutrophils: 67.8%, lymphocytes: 7%), serum creatinine was 1.2 mg/dL. Thyroid and liver function tests were within normal limits. The patient underwent left lower limb venous Doppler, which showed evidence of deep vein thrombosis in left common femoral vein extending across saphenofemoral junction into the great saphenous vein [Table/Fig-1]. Diffuse subcutaneous oedema and thickening of fat planes were noted in the left lower limb.