PMC3271454_01
Ultrasound abdomen reveals a large, well encapsulated, heterogeneous left suprarenal mass
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F1
Double echo chemical shift gradient echo imaging [Figure 1f] demonstrated few focal areas of signal loss in out-of-phase image as compared to in-phase image, consistent with the presence of microscopic (intracellular) fat, while the major portion of the mass demonstrated high signal intensity consistent with the presence of macroscopic (extracellular) fat.
PMC3271454_02
Ultrasound abdomen reveals a large, well encapsulated, heterogeneous left suprarenal mass
UA-4-55-g001.jpg
PMC3271454_02_UA-4-55-g001.jpg
F1
Double echo chemical shift gradient echo imaging [Figure 1f] demonstrated few focal areas of signal loss in out-of-phase image as compared to in-phase image, consistent with the presence of microscopic (intracellular) fat, while the major portion of the mass demonstrated high signal intensity consistent with the presence of macroscopic (extracellular) fat.
On axial plain and contrast-enhanced computed tomography images through upper abdomen, the mass appears to be well circumscribed and predominantly of fat density (-30 to -90 HU). Heterogeneous enhancement pattern is due to presence of enhancing soft tissue component (myeloid tissue) and septations. Few tiny flecks of calcifications are also visible in the lateral wall of the mass
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F2
Ultrasound examination of abdomen showed a huge, well encapsulated, solid echogenic mass lesion between the liver and right kidney [Figure 2a]. Plain and contrast CT abdomen [Figure 2b] revealed a well circumscribed 83.9 (AP) x 72.2 (TR) x 104.4 (SI) mm sized right suprarenal mass predominantly of fat density (-50 to -90 HU) with peripheral small enhancing soft tissue component on the postero-medial aspect of the mass. Suprarenal nature of the mass was confirmed by coronal and sagittal CT images [Figure 2c], which also showed postero-inferior displacement of right kidney. T1-and T2-weighted image [Figure 2d]. T2W-fat-suppression image [Figure 2e] showed loss of signal from large fatty portion of the mass, but persistence of increased signal intensity in areas occupied by hematopoietic tissue and intratumoral hemorrhage.