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Related Concept Videos

Anatomy of the Adrenal Glands01:17

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Related Experiment Video

Updated: Dec 28, 2025

A Novel Method: Super-selective Adrenal Venous Sampling
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Radiologically defined lipid-poor adrenal adenomas: histopathological characteristics.

A De Leo1, C Mosconi2, G Zavatta3

  • 1Pathology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.

Journal of Endocrinological Investigation
|February 17, 2020
PubMed
Summary
This summary is machine-generated.

Adrenal lipid-poor adenomas (LPAs) are often oncocytomas, with a significant portion showing borderline-malignant potential on histopathology. Further characterization is needed for these common adrenal lesions.

Keywords:
Adrenal oncocytomaAdrenal tumorBorderline-malignantLipid-poor adenoma

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Area of Science:

  • Endocrinology
  • Radiology
  • Pathology

Background:

  • Adrenal lipid-poor adenomas (LPAs) are characterized by specific CT findings: high unenhanced density (≥10 HU) and washout ratios >60% (absolute) and >40% (relative).
  • LPAs constitute approximately one-third of all adrenal adenomas, yet detailed histopathological characterization remains limited.
  • This study aimed to elucidate the histopathological features of adrenal LPAs.

Purpose of the Study:

  • To perform a thorough histopathological analysis of adrenal lipid-poor adenomas (LPAs).
  • To investigate the potential for borderline-malignant characteristics within these lesions.

Main Methods:

  • Retrospective analysis of 57 patients with LPAs, including those with adrenal incidentaloma or ACTH-independent Cushing syndrome.
  • FDG-PET was performed in 37 patients; histopathological evaluation (Weiss score, Lin-Weiss-Bisceglia score) was conducted on 17 adrenalectomy specimens.
  • Tumor characteristics were correlated with clinical presentation and radiological findings.

Main Results:

  • No significant differences in radiological parameters were observed across different clinical presentations (Cushing syndrome, aldosteronism, autonomous cortisol secretion, non-functioning).
  • Operated patients had larger tumors, higher CT unenhanced density, and increased FDG-PET uptake compared to non-operated patients.
  • Oncocytic features (>75%) were found in 70.6% of tumors; 35.3% of all evaluated tumors exhibited borderline-malignant potential based on histopathology.

Conclusions:

  • Adrenal LPAs represent a heterogeneous group of tumors, predominantly composed of oncocytomas.
  • A substantial proportion (up to one-third) of adrenal LPAs may possess borderline-malignant potential upon histopathological examination.
  • These findings highlight the importance of detailed histopathological assessment for adrenal LPAs.