The discovery of bilateral adrenal incidentaloma in an elderly male having nonspecific symptoms of weight loss and abdominal pain raises the suspicion of adrenal tuberculosis, histoplasmosis, or other deep fungal infection, malignancy, or metastasis. In an endemic region of TB, disseminated histoplasmosis is often misdiagnosed and treated as TB. So, a high index of suspicion is mandatory while dealing with such a case where the ultimate diagnosis relies on adrenal FNAC and histopathology. The following scenario highlights such a unique presentation of disseminated histoplasmosis where the initial inconclusive histopathology created much confusion before the final diagnosis could be made by reviewing the reports.