CT - Contrast enhanced CT abdomen pelvis
Axial C+ portal venous phase
Coronal C+ portal venous phase
List three differential diagnoses.
1. Adrenal extramedullary haematopoietic tumour 2. Adrenocortical carcinoma/adrenal metastasis 3. Phaeochromocytoma
There is a well circumscribed heterogeneous large right adrenal mass measuring 6.7 x 6.7 x 9.1 cm (AP x ML x CC). It has central necrosis. The soft tissue component demonstrates enhancement on the portovenous phase. No calcification or fatty component within. No surrounding fat streakiness.
On coronal images, it causing mass effect onto the right kidney.
Hepatosplenomegaly and cholelithiasis.
No ascites.
Impression: Right adrenal mass with underlying haematological disorder suggestive of extramedullary hematopoietic tumour.