Adrenal lesions (differential)

Last revised by Lotof Hassan Hamdan on 26 Nov 2024

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Hamdan L, Chang D, et al. Adrenal lesions (differential). Reference article, Radiopaedia.org (Accessed on 03 Dec 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:

26 Nov 2024, Lotof Hassan Hamdan

Disclosures:

At the time the article was last revised Lotof Hassan Hamdan had no financial relationships to ineligible companies to disclose.

View Lotof Hassan Hamdan's current disclosures

Revisions:

31 times, by 18 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

Incoming Links

Promoted articles (advertising)

{"current_user":null,"inclusions":[{"imageId":796,"studyId":6298,"caseSlug":"adrenal-adenoma-5","caption":"Case 1: adrenal adenoma","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/796/ea91adae6ffc6b68e80e069d74814c_big_gallery.jpeg"},{"imageId":28007,"studyId":7959,"caseSlug":"adrenal-cortical-carcinoma-3","caption":"Case 2: adrenal carcinoma","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/28007/e2f23ef3348600f5e285d4ae425a38b22f9f7039e266c4f1857f1346bf25ce9b_big_gallery.jpeg"},{"imageId":28042,"studyId":7960,"caseSlug":"adrenal-myelolipoma","caption":"Case 3: adrenal myelolipoma","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/28042/04bbc508086b5253744b7660abe1cd_big_gallery.jpg"},{"imageId":555948,"studyId":11445,"caseSlug":"adrenal-haemangioma","caption":"Case 5: adrenal hemangioma","isStack":true,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/555948/e81c0113e00a9f84645f6bfa4a95ef_big_gallery.jpg"},{"imageId":2252088,"studyId":19108,"caseSlug":"adrenal-metastasis-from-small-cell-lung-cancer","caption":"Case 7: adrenal metastases","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/2252088/21d33ce128562490d1b87582f7b190_big_gallery.jpg"},{"imageId":21507498,"studyId":48073,"caseSlug":"adrenal-pseudocyst-1","caption":"Case 8: adrenal pseudocyst","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/21507498/24b7fffe574b4cbfe34d05be97dbe46ccd44dc98bfc6bd333aefc8b636608e7a_big_gallery.jpeg"},{"imageId":28975187,"studyId":57366,"caseSlug":"extramedullary-haematopoiesis-adrenal","caption":"Case 9: extramedullary hematopoiesis","isStack":true,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/28975187/7874417705c4a2727b60710fe1b4aa77c768decac407e29f376666c2c12330c3_big_gallery.jpeg"},{"imageId":29175563,"studyId":57835,"caseSlug":"adrenal-epithelial-cyst","caption":"Case 10: adrenal epithelial cyst","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/29175563/2dafef45e9a8e99c481c9da3d24c36_big_gallery.jpeg"},{"imageId":42434451,"studyId":71537,"caseSlug":"bilateral-adrenal-myelolipoma-1","caption":"Case 11: bilateral adrenal myelolipoma","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/42434451/9dc4277e682dce032ca0da6fa1b5af_big_gallery.jpeg"},{"imageId":55172503,"studyId":107425,"caseSlug":"adrenal-cystic-lymphangioma-1","caption":"Case 12: adrenal cystic lymphangioma","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/55172503/330105_big_gallery.jpeg"},{"imageId":68514522,"studyId":157505,"caseSlug":"adrenal-cortical-carcinoma-11","caption":"Case 13: adrenal cortical carcinoma","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/68514522/d5bd080d7c0cfe15fd13289a3c5ee98ccd7398ec2fb227587fc12ca537da652b_big_gallery.jpeg"}],"ddx_inclusions":[{"imageId":53738530,"studyId":98578,"caseSlug":"gastric-diverticulum-14","caption":"Gastric diverticulum","isStack":true,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/53738530/IMG-0001-00267_big_gallery.jpeg"}],"lang":"us"}