Type:
Educational Exhibit
Keywords:
Education and training, Education, Diagnostic procedure, Ultrasound, MR, CT, Abdomen
Authors:
H. M. H. Lee1, G. Bittencourt Basso1, D. Moreira Furlanetto2, L. Saad1, V. C. R. Fiorot1, D. A. Rangel1, A. Curado Sobral Costa1, F. Lewin1; 1São Paulo/BR, 2102, RS/BR
DOI:
10.1594/ecr2018/C-2520
Background
The adrenal glands are paired organs of the endocrine system that lie in the perirenal space of the retroperitoneum; each of them is composed of a body and two limbs (medial and lateral),
weighs about 4-5 g,
and typically has an inverted-V,
Y or T shape.
The adrenal glands receive blood supply from the superior,
middle and inferior suprarenal arteries,
which originate from the inferior phrenic arteries,
abdominal aorta,
and renal arteries,
respectively.
The venous drainage of each adrenal gland is via a single vein that emerges from each adrenal gland as a suprarenal vein,
and empties it into the inferior vena cava on the right side,
and into the left renal vein or inferior phrenic vein on the left.
Each adrenal gland has two parts with different embryogenesis,
structure and function (Table 1): the medulla,
which is derived from the neural crest,
and the cortex,
which is derived from the mesoderm.
The cortex is further subdivided into three zones; each one produces a different type of hormone that determines different clinical manifestations: the outermost layer is the glomerulosa,
which produces aldosterone; the middle is the fasciculata,
which produces cortisol; and the innermost one is the reticularis,
which secretes androgens.
The medulla secretes epinephrine and norepinephrine.
The adrenal glands are a common site for numerous diseases,
including adenomas,
hemorrhage,
primary malignancy and metastasis.
On asymptomatic patients who undergo imaging examination to assess other conditions,
adrenal masses are typically found as an “incidentaloma”.
The discovery of an unsuspected adrenal mass is common,
occurring in up to 5% of patients undergoing abdominal computed tomography.