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Changing Role of Imaging-Guided Percutaneous Biopsy of Adrenal Masses: Evaluation of 50 Adrenal Biopsies

Sean D. Paulsen1, Hanh V. Nghiem, Melvyn Korobkin, Elaine M. Caoili and Ellen J. Higgins

1 All authors: Department of Radiology, University of Michigan, 1500 E Medical Center Dr., UH B1 D530, Ann Arbor, MI 48109.



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  		Fig. 1A. —Adrenal CT in 71-year-old man with biopsy-proven 2.5-cm adenoma in left adrenal gland. Unenhanced CT scan shows left adrenal mass (arrow) with attenuation value of 15 H.

 


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  		Fig. 1B. —Adrenal CT in 71-year-old man with biopsy-proven 2.5-cm adenoma in left adrenal gland. Contrast-enhanced CT scan shows homogeneous enhancement of left adrenal mass (arrow). Calculated percentage of enhancement washout value after contrast administration was 52%, not diagnostic for adenoma. Biopsy established diagnosis of adenoma.

 


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  		Fig. 2A. —Bilateral adrenal adenomas containing dystrophic calcifications in 80-year-old man with history of esophageal cancer. Unenhanced CT scan of right adrenal mass (arrow) shows coarse calcifications.

 


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  		Fig. 2B. —Bilateral adrenal adenomas containing dystrophic calcifications in 80-year-old man with history of esophageal cancer. Unenhanced CT scan of left adrenal mass (arrow) shows several scattered small calcifications. Unenhanced and contrast-enhanced washout values of both right and left adrenal masses were supportive of diagnoses of adenomas. However, because of presence of calcifications and mild uptake at PET, biopsy was performed and showed left mass to be adrenal adenoma.

 

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