PMC8364425_01
Pre- and postcontrast CT scan of the abdomen: large heterogeneous solid left adrenal mass (M) with internal calcifications and peripheral discontinuous enhancement after contrast (arrows in B and D). Note. Significant mass effect of the left kidney which is pushed inferiorly.
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fig1
Pre- and postcontrast abdominal CT scans (Figure 1) revealed a large heterogeneous solid left adrenal gland mass with internal calcifications and central necrosis. Postcontrast showed peripheral nodular discontinuous enhancement (Figure 1; B + D).
The gross examination of adrenal hemangioma (a) before and (b) after slicing, on the cut section, shows a cystic area with extensive hemorrhage.
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fig2
The residual adrenal gland could be identified (Figure 2).
Microscopic examination of the adrenal cavernous hemangioma showing cystic dilated vascular spaces filled with blood and lined with a single layer of mature endothelium, with adjacent compressed adrenal gland (hematoxylin-eosin staining x40).
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The annular structure was nonbirefringent when viewed under polarized-light microscopy, and on immunohistochemistry, the cystic lining tested positive for CD34 and CD31 (Figures 3 and 4).
Microscopic examination showing fibrinous matrix with many basophilic, lamellar structures (the rare: Liesegang ring) (hematoxylin-eosin staining x100).
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fig4
The annular structure was nonbirefringent when viewed under polarized-light microscopy, and on immunohistochemistry, the cystic lining tested positive for CD34 and CD31 (Figures 3 and 4).