Clinical, Pathological and CT Imaging Analysis of AT-AG (Three Cases and Literature Review)

Abstract

Background: Adenomatoid Tumor of the Adrenal Gland (AT-AG) are very rare. As the most commonly used clinical examination program, CT scan can make benign and malignant diagnosis by evaluating the characteristics of lesion shape, density and blood vessels, and provide imaging basis for treatment decisions.
Objective: To investigate the clinical, pathological and CT imaging features of AT-AG.
Methods: The clinical, pathological and CT findings of three AT-AG patients confirmed by surgery or pathology were reviewed and analyzed with reference to nine cases in literature reports.
Results: Among the 12 patients with AT-AG, 11 were male, with a median age of 40 years; 11 were diagnosed by physical examination or accident, while 1 was treated for right lumbago. Pathologically, they were characterized by microcapsule/glandular tube structures, absence of cell heteromorphosis and mitosis, positive immunohistochemical mesothelial markers, and negative endothelial markers; In addition, all of them were confirmed with single adrenal cystic or cystic solid masses on CT, including 2 with multilocular cyst and 3 with calcification. Among them, nine (75%) were oval, with the long diameter parallel to the long axis of adrenal gland, and 8 (67%) showed mild and moderate enhancement of capsule wall and solid components on enhanced scan.
Conclusion: AT-AG is more common in young and middle-aged men than other population groups, and it constitutes microcapsule/glandular structures under microscope. Its immune histo chemical mesothelial markers show positive, while endothelial markers are negative. CT findings reveal a mostly oval solitary cyst or solid mass, parallel to the long axis of adrenal gland, with mild and moderate enhancement on enhanced CT scan. Thus, being familiar with the clinical, pathological and CT features of AT-AG helps boost the understanding of the disease