title: Ultrasonographic features of adrenal gland lesions in dogs can aid in diagnosis.
abstract: BACKGROUND
  Ultrasonography to visualize adrenal gland lesions and evaluate incidentally discovered adrenal masses in dogs has become more reliable with advances in imaging techniques. However, correlations between sonographic and histopathological changes have been elusive. The goal of our study was to investigate which ultrasound features of adrenal gland abnormalities could aid in discriminating between benign and malignant lesions. To this end, we compared diagnosis based on ultrasound appearance and histological findings and evaluated ultrasound criteria for predicting malignancy.
  
  
  RESULTS
  Clinical records of 119 dogs that had undergone ultrasound adrenal gland and histological examination were reviewed. Of these, 50 dogs had normal adrenal glands whereas 69 showed pathological ones. Lesions based on histology were classified as cortical adrenal hyperplasia (n = 67), adenocarcinoma (n = 17), pheochromocytoma (n = 10), metastases (n = 7), adrenal adenoma (n = 4), and adrenalitis (n = 4). Ultrasonographic examination showed high specificity (100%) but low sensitivity (63.7%) for identifying the adrenal lesions, which improved with increasing lesion size. Analysis of ultrasonographic predictive parameters showed a significant association between lesion size and malignant tumors. All adrenal gland lesions >20 mm in diameter were histologically confirmed as malignant neoplasms (pheochromocytoma and adenocarcinoma). Vascular invasion was a specific but not sensitive predictor of malignancy. As nodular shape was associated with benign lesions and irregular enlargement with malignant ones, this parameter could be used as diagnostic tool. Bilaterality of adrenal lesions was a useful ultrasonographic criterion for predicting benign lesions, as cortical hyperplasia.
  
  
  CONCLUSIONS
  Abnormal appearance of structural features on ultrasound images (e.g., adrenal gland lesion size, shape, laterality, and echotexture) may aid in diagnosis, but these features alone were not pathognomic. Lesion size was the most direct ultrasound predictive criterion. Large and irregular masses seemed to be better predictors of malignant neoplasia and lesions <20 mm in diameter and nodular in shape were often identified as cortical hyperplastic nodules or adenomas.
authors.affiliation: Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2-5, 10095, Grugliasco, TO, Italy. elena.pagani@unito.it.
authors.forename: Elena
authors.initials: E
authors.lastname: Pagani
authors.affiliation: Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2-5, 10095, Grugliasco, TO, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Tursi
authors.affiliation: Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2-5, 10095, Grugliasco, TO, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Lorenzi
authors.affiliation: Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2-5, 10095, Grugliasco, TO, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Tarducci
authors.affiliation: Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2-5, 10095, Grugliasco, TO, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bruno
authors.affiliation: Department of Agriculture, Forest and Food Sciences, University of Turin, L. Paolo Braccini, 2, 10095, Grugliasco, TO, Italy.
authors.forename: Enrico Corrado
authors.initials: EC
authors.lastname: Borgogno Mondino
authors.affiliation: Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2-5, 10095, Grugliasco, TO, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Zanatta
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000662:veterinary*; D000311:Adrenal Glands / Q000000981:diagnostic imaging*; D000818:Animals; D004283:Dog Diseases / Q000000981:diagnostic imaging*; D004285:Dogs; D005260:Female; D008297:Male; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000662:veterinary*
keywords: Adrenal gland; Dogs; Lesion; Tumor; Ultrasonography