Adrenal Gland

Question 1

Adrenal adenoma washout equation

Diagnostic washout percentage

Answer 1

(Enhanced - Delayed)/ (Enhanced - Unenhanced)

> 60%

Question 3

Pheos found in what syndromes

Answer 3

MEN2A/B
VHL
NF1
Carney’s triad (gastric leiomyosarcoma, pulmonary chondroma, extra adrenal pheo)

Question 4

Timing for adrenal protocol CT

Answer 4

1) Precontrast
2) 60-70 second delay (adrenal parenchymal phase)
3) 10-15 minute delay

Question 5

Predominantly fatty adrenal mass with well circumscribed foci of soft tissue attenuation

Answer 5

Myelolipoma

Myelo = myeloid = erythrocyte precursors

Question 6

What is the most common location of an extra adrenal pheochromocytoma (paraganglioma)?

Answer 6

The organ of Zuckerkandle at the aortic bifurcation.

Question 7

Paragangliomas occur in the head and neck and characteristic locations. Name the location and name of the four most common Paragangliomas.

Answer 7

Tympanic membrane = glomus tympanicum

Jugular foramen = glomus jugulare

Carotid body = carotid body tumor

Vagus nerve = glomus vagale

Question 8

What nuclear medicine studies are used for the work up of Pheochromocytoma?

Answer 8

I-123 MIBG (Metastatic work up)

Indium 111 pentetreotide (localization)

Question 9

What are the most common metastatic cancer’s to the adrenal glands?

Answer 9

Lung cancer and melanoma