Sakano Maho, Wakabayashi Yukari, Shirota Natsuhiko, Ohno Yoshio, Suketa Aoi, Nagao Toshitaka, Saito Kazuhiro
Department of Radiology, Tokyo Medical University, Shinjuku-ku, Tokyo, 1600023, Japan.
Departmet of Urology, Tokyo Medical University, Shinjuku-ku, Tokyo, 1600023, Japan.
BJR Case Rep. 2024 Aug 30;10(5):uaae029. doi: 10.1093/bjrcr/uaae029. eCollection 2024 Sep.
Oncocytoma is a tumour that predominantly occurs in the kidneys and salivary glands. Only approximately 200 cases have been reported to be of adrenal origin to date, and only a few reports about its radiological findings have been published so far. Herein, we present the CT and MRI findings of an adrenal oncocytoma observed in a patient suspected of having mitochondrial abnormalities, along with the pathological findings. The tumour was roughly classified into three areas: a hypercellular region, a region containing fibrous tissue, and an oedematous region. These corresponded to the restricted diffusion area on the apparent diffusion coefficient map, the gradually enhanced area at the secretory phase on contrast-enhanced CT scan, and the obvious hyperintensity on the T2-weighted image, respectively. We also discuss these findings in the context of previously reported radiological findings in the literature. Diagnosing adrenal oncocytoma through imaging is challenging, and it is crucial to consider the possibility of malignancy while making the differential diagnosis. Small-sized homogenous tumours may be hard to differentiate from lipid-poor adenomas, while larger inhomogeneous ones are hard to distinguish from adrenal cancer.
嗜酸细胞瘤是一种主要发生于肾脏和唾液腺的肿瘤。迄今为止,仅有约200例报告显示其起源于肾上腺,且目前仅有少数关于其影像学表现的报道发表。在此,我们展示了一名疑似存在线粒体异常患者的肾上腺嗜酸细胞瘤的CT和MRI表现以及病理结果。肿瘤大致分为三个区域:高细胞区、含纤维组织区和水肿区。这些区域分别对应表观扩散系数图上的扩散受限区、增强CT扫描分泌期的逐渐强化区以及T2加权图像上的明显高信号。我们还结合文献中先前报道的影像学表现对这些结果进行了讨论。通过影像学诊断肾上腺嗜酸细胞瘤具有挑战性,在进行鉴别诊断时考虑恶性可能性至关重要。小尺寸的均匀肿瘤可能难以与乏脂性腺瘤区分,而较大的不均匀肿瘤则难以与肾上腺癌区分。