Adrenal adenomas: Relationship between histologic lipid-rich cells and CT attenuation number

Takayuki Yamada, Tadashi Ishibashi, Haruo Saito, Toshio Matsuhashi, Kazuhiro Majima, Masashi Tsuda, Shoki Takahashi, Takuya Moriya

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)


Objective: To evaluate the relationship between lipid-rich cells of the adrenal adenoma and precontrast computed tomographic (CT) attenuation numbers in three clinical groups. Materials and Methods: Thirty-five surgically resected adrenal adenomas were used. The clinical diagnoses of the patients included 13 cases of primary aldosteronism, 15 cases of Cushing's syndrome, and 7 non-functioning tumors. The number of lipid-rich clear cells was counted using a microscopic eyepiece grid that contained 100 squares. The results were expressed as the percentages of lipid-rich areas. Results: There was a strong inverse linear relationship between the percentage of lipid-rich cells and the precontrast CT attenuation number (R2=0.724, P<0.0001). There were significantly more lipid-rich cells in the primary aldosteronism and non-functioning tumor cases compared to cases of Cushing's syndrome (P=0.007 and 0.015, respectively). The CT attenuation numbers of the primary aldosteronism cases were significantly lower than those of Cushing's syndrome (P=0.0052). Furthermore, the CT attenuation numbers of the non-functioning tumor cases were lower than those of Cushing's syndrome cases. Conclusion: We showed that adrenal adenomas in primary aldosteronism and non-functioning tumors contain significantly more lipid-rich cells than those in Cushing's syndrome. They also showed significantly lower attenuation than that in Cushing's syndrome on CT scans. Our results suggest that precontrast CT attenuation numbers may be helpful in the differentiation of adenomas from non-adenomatous lesions, which include malignancies.

Original languageEnglish
Pages (from-to)198-202
Number of pages5
JournalEuropean Journal of Radiology
Issue number2
Publication statusPublished - 2003 Nov


  • Adrenal adenoma
  • Aldosteronism
  • Cushing's syndrome
  • Non-functioning tumor

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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