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Cystic adrenal lesions: CT features

A Rozenblit1, H T Morehouse, E S Amis

  • 1Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA.

Radiology
|November 1, 1996
PubMed
Summary

Computed tomography (CT) can differentiate adrenal cysts from adenomas by identifying nonenhancing masses, potentially with wall calcification. Small adrenal cysts with near-water attenuation and thin walls are likely benign.

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Area of Science:

  • Radiology
  • Oncology
  • Endocrinology

Background:

  • Adrenal lesions present a diagnostic challenge, with cystic lesions requiring differentiation from adenomas.
  • Accurate characterization of adrenal cysts is crucial for appropriate management.

Purpose of the Study:

  • To define computed tomographic (CT) features that distinguish cystic adrenal lesions from adenomas.
  • To identify imaging characteristics indicative of benign adrenal cysts.

Main Methods:

  • Retrospective analysis of CT scans from 13 cystic adrenal lesions with diverse histologies.
  • Review of literature data on 26 additional benign adrenal cysts.
  • Evaluation of lesion size, attenuation, calcification, wall thickness, and enhancement patterns.

Main Results:

  • Mean lesion diameter was 6.2 cm; mean attenuation was 21 HU.
  • Wall or septal calcification was present in 10 lesions.
  • Thin walls (≤3 mm) were observed in nine lesions, while thicker walls (>6 mm) were noted in three, including one carcinoma.
  • Nonenhancing masses with or without calcification were characteristic of adrenal cysts.

Conclusions:

  • CT findings of nonenhancing masses with or without wall calcification aid in differentiating adrenal cysts from adenomas.
  • Small adrenal cysts with near-water attenuation and thin walls are likely benign.

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