CT configuration of the enlarged adrenal gland

Computed tomography was used to study 31 enlarged adrenal glands in 26 patients. The specific diagnoses were: 12 metastases, 7 pheochromocytomas, 7 adenomas, 2 carcinomas, 2 adrenal hemorrhages, and 1 cyst. Enlarged adrenal glands were frequently found to have an elongated, ovoid cross-sectional appearance. Twenty-four of the 31 adrenal glands (77%) had a length to width ratio of 1.2 or greater. The limited space available for uniform concentric expansion of of the enlarging gland appears to be the chief factor causing adrenal masses to assume an ovoid shape. Inasmuch as the upper pole of the unenhanced kidney and the inferior vena cava may both exhibit a similar cross-sectional appearance, cognizance of the potential ovoid configuration of the enlarged adrenal gland should facilitate detection of adrenal masses.