Adrenal lesions (differential)

Last revised by David Chang on 8 Mar 2024

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Chang D, Knipe H, et al. Adrenal lesions (differential). Reference article, Radiopaedia.org (Accessed on 18 Apr 2024) https://doi.org/10.53347/rID-7972

DOI:

https://doi.org/10.53347/rID-7972

Permalink:

https://radiopaedia.org/articles/7972?iframe=true

rID:

7972

Article created:

25 Dec 2009, Yuranga Weerakkody ◉

Disclosures:

At the time the article was created Yuranga Weerakkody had no recorded disclosures.

View Yuranga Weerakkody's current disclosures

Last revised:

8 Mar 2024, David Chang

Disclosures:

At the time the article was last revised David Chang had no financial relationships to ineligible companies to disclose.

View David Chang's current disclosures

Revisions:

30 times, by 17 contributors - see full revision history and disclosures

Systems:

Urogenital

Tags:

adrenal gland, endocrine, differential

Synonyms:

Unilateral adrenal mass
Adrenal lesions : differential diagnosis
Differential diagnosis of adrenal lesions
Adrenal nodules (differential )
Adrenal masses (differential )
Adrenal incidentalomas (differential)
Unilateral adrenomegaly

Adrenal lesions cover a broad spectrum from benign to neoplastic entities. Due to increased use of cross-sectional imaging they are frequently detected as incidental lesions (incidentalomas). If found incidentally, please refer to the Management of Incidental Adrenal Masses: American College of Radiology White Paper ⁹.

Radiology plays a significant role in differentiation. Cross-sectional imaging is the mainstay of imaging for identifying and assessing adrenal lesions, for which an algorithm to aid characterization is helpful ⁵. Adrenal enlargement is also - rarely - called adrenomegaly, which can be unilateral or bilateral.

Small unilateral adrenal mass

adrenal adenoma: most common lesion detected on CT ^5,6
adrenal metastasis
pheochromocytoma
asymmetric adrenal cortical hyperplasia
adrenal granulomatous disease
- tuberculosis
- histoplasmosis
adrenal myelolipoma

Large solid adrenal mass

Cystic lesions

Other lesions

Other adrenal pathology

adrenal calcification
- Wolman disease

Quiz questions

References

1. Elsayes KM, Mukundan G, Narra VR et-al. Adrenal masses: mr imaging features with pathologic correlation. Radiographics. 2004;24 Suppl 1 (suppl 1): S73-86. doi:10.1148/rg.24si045514 - Pubmed citation
2. Mayo-smith WW, Boland GW, Noto RB et-al. State-of-the-art adrenal imaging. Radiographics. 21 (4): 995-1012. Radiographics (full text) - Pubmed citation
3. Rozenblit A, Morehouse HT, Amis ES. Cystic adrenal lesions: CT features. Radiology. 1996;201 (2): 541-8. Radiology (abstract) - Pubmed citation
4. Miller JC, Blake MA, Boland GW. Definitive characterisation of adrenal lesions. BMJ. 2009;338 (jan19 1): a3092. doi:10.1136/bmj.a3092 - Pubmed citation
5. Boland GW, Blake MA, Hahn PF et-al. Incidental adrenal lesions: principles, techniques, and algorithms for imaging characterization. Radiology. 2008;249 (3): 756-75. doi:10.1148/radiol.2493070976 - Pubmed citation
6. Song JH, Chaudhry FS, Mayo-smith WW. The incidental adrenal mass on CT: prevalence of adrenal disease in 1,049 consecutive adrenal masses in patients with no known malignancy. AJR Am J Roentgenol. 2008;190 (5): 1163-8. doi:10.2214/AJR.07.2799 - Pubmed citation
7. Karami H, Kosaryan M, Taghipour M, Sharifian R, Aliasgharian A, Motalebi M. Extramedullary hematopoiesis presenting as a right adrenal mass in a patient with Beta thalassemia. Nephro-urology monthly. 6 (5): e19465. doi:10.5812/numonthly.19465 - Pubmed
8. Wolfgang Dähnert. Radiology Review Manual. (2011) ISBN: 9781609139438
9. Mayo-Smith WW, Song JH, Boland GL, Francis IR, Israel GM, Mazzaglia PJ, Berland LL, Pandharipande PV. Management of Incidental Adrenal Masses: A White Paper of the ACR Incidental Findings Committee. (2017) Journal of the American College of Radiology : JACR. 14 (8): 1038-1044. doi:10.1016/j.jacr.2017.05.001 - Pubmed 14:1038-1044
10. Nicola Schieda, Evan S. Siegelman. Update on CT and MRI of Adrenal Nodules. (2017) American Journal of Roentgenology. doi:10.2214/AJR.16.17758
11. Song J, Grand D, Beland M, Chang K, Machan J, Mayo-Smith W. Morphologic Features of 211 Adrenal Masses at Initial Contrast-Enhanced CT: Can We Differentiate Benign From Malignant Lesions Using Imaging Features Alone? AJR Am J Roentgenol. 2013;201(6):1248-53. doi:10.2214/ajr.12.10302 - Pubmed

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