Incidentaloma differential diagnosis: Difference between revisions
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! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}} | ! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}} | ||
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF| | ! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Clinical picture}} | ||
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF| | ! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Imagings and labs}} | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Adrenal adenoma | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* | * | ||
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* Round and homogeneous density, smooth contour and sharp margination [15] | |||
* Diameter less than 4 cm, unilateral location | |||
* Low unenhanced CT attenuation values (<10 HU) (image 1) | |||
* Rapid contrast medium washout (10 minutes after administration of contrast, an absolute contrast medium washout of more than 50 percent) | |||
* Isointensity with liver on both T1 and T2 weighted MRI sequences | |||
* Chemical shift evidence of lipid on MRI | |||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Adrenocortica'''l carcinoma | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* | * | ||
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* Irregular shape | |||
* Inhomogeneous density because of central areas of low attenuation due to tumor necrosis (image 4) | |||
* Tumor calcification | |||
* Diameter usually >4 cm | |||
* Unilateral location | |||
* High unenhanced CT attenuation values (>20 HU) | |||
* Inhomogeneous enhancement on CT with intravenous contrast | |||
* Delay in contrast medium washout (10 minutes after administration of contrast, an absolute contrast medium washout of less than 50 percent) | |||
* Hypointensity compared with liver on T1 weighted MRI and high to intermediate signal intensity on T2 weighted MRI | |||
* High standardized uptake value (SUV) on FDG-PET-CT study | |||
* Evidence of local invasion or metastases | |||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Pheochromocytoma | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* | * | ||
| | | | ||
* Increased attenuation on nonenhanced CT (>20 HU) | |||
* Increased mass vascularity (image 2) | |||
* Delay in contrast medium washout (10 minutes after administration of contrast, an absolute contrast medium washout of less than 50 percent) | |||
* High signal intensity on T2 weighted MRI (image 3) | |||
* Cystic and hemorrhagic changes | |||
* Variable size and may be bilateral | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Adrenal metastasis | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* | * | ||
| | | | ||
* Irregular shape and inhomogeneous nature | |||
* Tendency to be bilateral | |||
* High unenhanced CT attenuation values (>20 HU) and enhancement with intravenous contrast on CT | |||
* Delay in contrast medium washout (10 minutes after administration of contrast, an absolute contrast medium washout of less than 50 percent) | |||
* Isointensity or slightly less intense than the liver on T1 weighted MRI and high to intermediate signal intensity on T2 weighted MRI (representing an increased water content) | |||
* Elevated standardized uptake value on FDG-PET scan | |||
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Revision as of 02:03, 30 August 2017
Incidentaloma Microchapters |
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Case Studies |
Incidentaloma differential diagnosis On the Web |
American Roentgen Ray Society Images of Incidentaloma differential diagnosis |
Risk calculators and risk factors for Incidentaloma differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
Differentiating Incidentaloma from other Diseases
- [Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3]
Differential Diagnosis | Clinical picture | Imagings and labs |
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Adrenal adenoma |
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Adrenocortical carcinoma |
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Pheochromocytoma |
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Adrenal metastasis |
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