PMC4643478_01
(a) noncontrast-enhanced CT scan showing encapsulate large right adrenal lesion with regular margins; (b-d) contrast-enhanced CT images obtained in arterial, portal and late phase, 3 min after iodinated contrast administration, showing a hypodense centre with no infiltration of peri-adrenal organs.
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After iodinated-contrast we observed a progressive, inhomogeneous enhancement without evidence of active bleeding and with pre-operative diagnosis of adrenal hemangioma (Fig. 1).
Resected adrenal gland with a smooth surface and adrenal vein.
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Pathological examination revealed a 11 cm x 7.5 cm x 7 cm adrenal mass weighted 260 g with peripheral sectors of regular adrenal tissue (Fig. 2).
(a) representative tissue section with residual adrenal parenchyma (H&E 10x); (b) multiple dilated interconnecting vascular channels with thrombosis (H&E 20x); (c) areas of hemorrhage and necrosis (H&E 40 x).
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Microscopically, extensive central necrotic areas were found mixed to sinusoidal dilation and fibrotic septa with post-operative diagnosis of adrenal hemangioma (Fig. 3).