Adrenal schwannoma: CT, MR manifestations and pathological correlation. 2018

Wei Tang, and Xiang-Rong Yu, and Liang-Ping Zhou, and Hong-Bo Gao, and Qi-Feng Wang, and Wei-Jun Peng
Department of Radiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

OBJECTIVE This study aimed to describe the computed tomography (CT), magnetic resonance imaging (MRI) imaging features of adrenal schwannoma and to correlate imaging findings with histopathologic findings. METHODS The findings from multiphase CT or MRI examinations of seventeen patients with histopathologically confirmed adrenal schwannoma were reviewed. The imaging criteria included shape, size, margin, attenuation, signal intensity, secondary degeneration, and internal mass enhancement pattern. RESULTS All cases were unilateral, round or oval solitary tumors, with diameters ranging from approximately 2.5 to 8.8 cm (median = 4.5 cm). Of the twelve cases assessed using CT, adrenal schwannoma appeared as well-circumscribed round or oval low-density suprarenal masses with a mean attenuation values of 30.1 HU of solid portions during unenhanced phase. Ten cases exhibited heterogeneous cyst formation, and one case showed calcification. Internal septa were noted in 5 cases. All solid areas displayed early mild heterogeneous enhancement and delayed progressive enhancement. Regarding MRI, solid portions of five masses were hypointense to the liver parenchyma on T1-weighted imaging (T1WI) and were heterogeneously hyperintense on T2-weighted imaging (T2WI). The enhanced pattern of solid areas of adrenal schwannoma on MRI is similar to that of CT. Cystic or hemorrhagic changes were noted in 4 cases and internal septa were noted in 3 cases. CONCLUSIONS Although schwannoma is a rare entity in the adrenal gland, we believe that the following signs may suggest the diagnosis of this entity: a non-lipid containing mass, a well-defined border, a unilateral mass with cystic or hemorrhagic degeneration, septa with delayed enhancement and a characteristic progressive contrast enhancement pattern of the solid portions.

UI MeSH Term Description Entries
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009442 Neurilemmoma A neoplasm that arises from SCHWANN CELLS of the cranial, peripheral, and autonomic nerves. Clinically, these tumors may present as a cranial neuropathy, abdominal or soft tissue mass, intracranial lesion, or with spinal cord compression. Histologically, these tumors are encapsulated, highly vascular, and composed of a homogenous pattern of biphasic fusiform-shaped cells that may have a palisaded appearance. (From DeVita Jr et al., Cancer: Principles and Practice of Oncology, 5th ed, pp964-5) Neurinoma,Schwannoma,Schwannomatosis, Plexiform,Neurilemoma,Neurilemmomas,Neurilemomas,Neurinomas,Plexiform Schwannomatoses,Plexiform Schwannomatosis,Schwannomas
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000310 Adrenal Gland Neoplasms Tumors or cancer of the ADRENAL GLANDS. Adrenal Cancer,Adrenal Gland Cancer,Adrenal Neoplasm,Cancer of the Adrenal Gland,Neoplasms, Adrenal Gland,Adrenal Cancers,Adrenal Gland Cancers,Adrenal Gland Neoplasm,Adrenal Neoplasms,Cancer, Adrenal,Cancer, Adrenal Gland,Cancers, Adrenal,Cancers, Adrenal Gland,Neoplasm, Adrenal,Neoplasm, Adrenal Gland,Neoplasms, Adrenal
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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