Adrenal gland
Other benign cortical lesions
Cysts

Author: Lan Gellert, M.D., Ph.D. (see Authors page)

Revised: 21 September 2016, last major update August 2016

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed Search: Cysts [title] adrenal

Related topics: Endothelial (vascular) cyst, Hemorrhagic cyst (pseudocyst), Lymphangioma, Parasitic cyst

Definition / General
  • Mostly incidental finding on imaging studies
  • Origin is endothelial (45%), pseudocyst (39%), epithelial (9%) or parasitic (7%) (Pathol Oncol Res 2005;11:242)
  • Most adrenal cysts are benign and non-functional
Essential Features
  • Origin is endothelial (45%), pseudocysts (39%), epithelial (9%) or parasitic (7%)
  • Most adrenal cysts are benign and non-functional
  • Vascular cyst most common
Epidemiology
  • Incidence of 0.06% in surgical series and 0.18% at autopsy (Radiology 1996;201:541)
  • Commonly present in fourth or fifth decade
  • Mostly women
Clinical Features
  • May produce mass or flank pain
Case Reports
Treatment
  • Simple cyst enucleation
  • Adrenalectomy
Clinical Images

Images hosted on other servers:

Giant endothelial lined adrenal cyst

Adrenal hydatid cyst

Adrenal bronchogenic cyst



Adrenal gland pseudocysts

Gross Description
  • Up to 30 cm, usually unilateral with irregular thick fibrous wall and calcifications
  • Often yellow, residual adrenocortical tissue in cystic wall
Gross Images

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Adrenal gland pseudocyst

Adrenal hydatid cyst

Micro Description
  • Variable depending on nature of cyst
  • Vascular cyst: cystic wall often lined by flattened endothelial cells
  • Pseudocyst: fibrous cystic wall with no endothelial or epithelial lining
Micro Images

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Adrenal pseudocyst



Adrenal lymphangioma

Adrenal hydatid cyst

Adrenal bronchogenic cyst

Positive Stains
Differential Diagnosis
  • Cystic degeneration of adrenocortical neoplasm positive for inhibin and MelanA (Mod Pathol 1997;10:530)
  • Malignant neoplasm: 7% of all adrenal cystic lesions