Hemosiderosis

Case contributed by Dr Vikas Shah

Presentation

CT to characterize adrenal lesion found on imaging elsewhere

CT

Low density left adrenal lesion.

High density throughout liver.

Normal spleen.

MRI

The left adrenal lesion has low signal on T1 weighted imaging and high signal on T2 and gradient echo imaging, likely to be cystic in nature.

Diffuse low signal throughout liver and spleen.

Case Discussion

This patient had frequent blood transfusions due to underlying myelofibrosis. In hemosiderosis, there is iron overload involving the liver and spleen, with a reduction in the signal intensity in these organs on the T1 in-phase images compared to the T1 out-of-phase images. This is the opposite pattern to diffuse steatosis. Secondary hemochromatosis may be associated with hemosiderosis, diagnosed when there is end organ damage.

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