title: CT Appearance of Adrenal Cystic Lymphangioma: Radiologic-Pathologic Correlation.
abstract: OBJECTIVE
  Cystic lymphangioma is an uncommon lesion in the adrenal gland. Because of the lesion's rarity, few descriptions of it can be found in the radiology literature. We therefore describe a series of these lesions with a focus on CT characteristics with correlation to gross and microscopic pathology features.
  
  
  METHODS
  Retrospective review identified seven patients with definitive pathologic findings of cystic lymphangioma of the adrenal gland and available diagnostic CT examinations. CT examinations were reviewed for key imaging features and correlated to gross and microscopic pathology. Lesions were generally described in corresponding reports as likely representing adenomas or hematomas based on CT findings.
  
  
  RESULTS
  All cystic lymphangiomas included in this series were well-circumscribed lesions with low-attenuation internal contents and thin walls, without evidence of solid components or nodularity. No measurable contrast enhancement was seen in these lesions. Six of the seven lesions contained calcifications with one of two patterns: either thick, curvilinear, and dystrophic-appearing or thin and scattered. On gross and microscopic pathology, the lesions were composed of dilated cystic spaces containing serous fluid and lined by bland endothelial cells.
  
  
  CONCLUSIONS
  Though rare, an adrenal cystic lymphangioma should be suspected on CT when a unilocular or multilocular, low-attenuation, nonenhancing lesion is present in the region of the adrenal gland, particularly if the lesion contains either of the above-noted calcification patterns. Recognition of these findings may allow more conservative treatment of selected patients harboring these lesions.
authors.affiliation: 1 Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, 601 N Caroline St, Baltimore, MD 21287.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Rowe
authors.affiliation: 2 Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD.
authors.forename: Justin A
authors.initials: JA
authors.lastname: Bishop
authors.affiliation: 3 Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Prescott
authors.affiliation: 4 Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins Hospital, Baltimore, MD.
authors.forename: Roberto
authors.initials: R
authors.lastname: Salvatori
authors.affiliation: 1 Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, 601 N Caroline St, Baltimore, MD 21287.
authors.forename: Elliot K
authors.initials: EK
authors.lastname: Fishman
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D018191:Lymphangioma, Cystic / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: CT; adrenal tumor; lymphangioma