{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T18:02:14Z","timestamp":1784311334326,"version":"3.55.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"1129","license":[{"start":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T00:00:00Z","timestamp":1634515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Adrenal adenoma with myelolipomatous degeneration (AMD) is a rarely reported and often overlooked entity. The aim of this study is to improve understanding of these lesions by characterizing the imaging findings with pathologic and clinical correlation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In the largest series to date, we report 11 nodules in 11 patients confirmed with a pathologic diagnosis of AMD. The available cross-sectional imaging and histopathologic features were reviewed by two radiologists and two pathologists, respectively. Clinical and laboratory data for each patient were obtained from the electronic medical records, when available.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>All 11 patients had a CT prior to resection or biopsy of the adrenal nodule, with five having received an adrenal mass protocol study. An MRI was available in three patients. The median size of the nodules on imaging was 4.5\u2009cm (range 2.8\u20138.7) and all but one had macroscopic fat. The largest focus of macroscopic fat had a median size of 0.7\u2009cm (range 0.2\u20131.6) and on average was 14.4% the size of the tumor, using greatest dimensions. Four (36.4%) patients had a diagnosis of Cushing syndrome prior to nodule resection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Not all adrenal nodules with macroscopic fat on imaging are pure myelolipomas. An AMD should be considered, especially if the foci of fat are small and other features of an adenoma are present. Some may also be associated with Cushing syndrome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge:<\/jats:title>\n                  <jats:p>Myelolipomatous degeneration within an adrenal adenoma has only rarely been previously reported with very few reports emphasizing the imaging features. There may be an association with cortisol hypersecretion and improved recognition of this entity could lead to changes in clinical management.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1259\/bjr.20210555","type":"journal-article","created":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T17:12:14Z","timestamp":1633713134000},"source":"Crossref","is-referenced-by-count":7,"title":["Imaging characteristics of pathologically proven adrenal adenomas with myelolipomatous degeneration: correlation with clinical and pathologic features"],"prefix":"10.1093","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8628-7062","authenticated-orcid":false,"given":"Jeffrey","family":"Guccione","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Imaging, Stanford University , Stanford, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moataz","family":"Soliman","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center , Houston, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center , Houston, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouhammed Amir","family":"Habra","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal disorders, The University of Texas MD Anderson Cancer Center , Houston, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Pathology, Indiana University , Indianapolis, IN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianping","family":"Zhao","sequence":"additional","affiliation":[{"name":"Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center , Houston, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled M","family":"Elsayes","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center , Houston, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,10,18]]},"reference":[{"key":"2024050310482564300_b1","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1530\/eje.0.1490273","article-title":"Prevalence and natural history of adrenal incidentalomas","volume":"149","author":"Barzon","year":"2003","journal-title":"Eur J Endocrinol"},{"key":"2024050310482564300_b2","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1530\/EJE-16-0467","article-title":"Management of adrenal incidentalomas: European Society of endocrinology clinical practice guideline in collaboration with the European network for the study of adrenal tumors","volume":"175","author":"Fassnacht","year":"2016","journal-title":"European Journal of Endocrinology"},{"key":"2024050310482564300_b3","doi-asserted-by":"crossref","first-page":"201","DOI":"10.2214\/ajr.171.1.9648789","article-title":"Characterization of adrenal masses using unenhanced CT: an analysis of the CT literature","volume":"171","author":"Boland","year":"1998","journal-title":"AJR Am J Roentgenol"},{"key":"2024050310482564300_b4","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1148\/radiol.2223010766","article-title":"Adrenal masses: characterization with combined unenhanced and delayed enhanced CT","volume":"222","author":"Caoili","year":"2002","journal-title":"Radiology"},{"key":"2024050310482564300_b5","doi-asserted-by":"crossref","first-page":"747","DOI":"10.2214\/ajr.170.3.9490968","article-title":"Ct time-attenuation washout curves of adrenal adenomas and nonadenomas","volume":"170","author":"Korobkin","year":"1998","journal-title":"AJR Am J Roentgenol"},{"key":"2024050310482564300_b6","doi-asserted-by":"crossref","first-page":"215","DOI":"10.2214\/ajr.183.1.1830215","article-title":"Comparison of unenhanced CT and chemical shift MRI in evaluating lipid-rich adrenal adenomas","volume":"183","author":"Israel","year":"2004","journal-title":"AJR Am J Roentgenol"},{"key":"2024050310482564300_b7","doi-asserted-by":"crossref","first-page":"R65","DOI":"10.1530\/ERC-16-0564","article-title":"Lipomatous tumours in adrenal gland: who updates and clinical implications","volume":"24","author":"Lam","year":"2017","journal-title":"Endocr Relat Cancer"},{"key":"2024050310482564300_b8","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1007\/s00261-019-02215-9","article-title":"Adrenal cortical adenoma: current update, imaging features, atypical findings, and mimics","volume":"45","author":"Elbanan","year":"2020","journal-title":"Abdom Radiol"},{"key":"2024050310482564300_b9","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1097\/00004728-198106000-00027","article-title":"Combined adrenal adenoma and myelolipoma","volume":"5","author":"Weiner","year":"1981","journal-title":"J Comput Assist Tomogr"},{"key":"2024050310482564300_b10","first-page":"895","article-title":"Hematopoietic elements associated with adrenal glands. A study of the spectrum of change in nine cases","volume":"118","author":"Goetz","year":"1994","journal-title":"Arch Pathol Lab Med"},{"key":"2024050310482564300_b11","first-page":"116","article-title":"Adrenal adenoma and myelolipoma in an elderly patient with Conn\u2019s syndrome","volume":"91","author":"Pasimeni","year":"2000","journal-title":"Recenti Prog Med"},{"key":"2024050310482564300_b12","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1081\/ERC-120018677","article-title":"Myelolipomatous Foci in an Adrenal Adenoma Causing Cushing\u2019s Syndrome?","volume":"29","author":"Vrezas","year":"2003","journal-title":"Endocr Res"},{"key":"2024050310482564300_b13","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/j.1442-2042.2004.00793.x","article-title":"Adrenal myelolipoma associated with adenoma","volume":"11","author":"Manassero","year":"2004","journal-title":"International Journal of Urology"},{"key":"2024050310482564300_b14","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1177\/106689690401200111","article-title":"Adrenal cortical adenoma with excess black pigment deposition, combined with myelolipoma and clinical cushing\u2019s syndrome: a case report and review of the literature","volume":"12","author":"Armand","year":"2004","journal-title":"Int J Surg Pathol"},{"key":"2024050310482564300_b15","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1111\/j.1440-1827.2004.01686.x","article-title":"Case of combined adrenal cortical adenoma and myelolipoma","volume":"54","author":"Matsuda","year":"2004","journal-title":"Pathol Int"},{"key":"2024050310482564300_b16","first-page":"e200","article-title":"Myelolipoma within a non-functional adrenal cortical adenoma","volume":"48","author":"Ong","year":"2007","journal-title":"Singapore Med J"},{"key":"2024050310482564300_b17","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1055\/s-0029-1202274","article-title":"Myelolipomatous Adrenal Masses Causing Cushing\u2019s Syndrome","volume":"117","author":"Lamas","year":"2009","journal-title":"Exp Clin Endocrinol Diabetes"},{"issue":"may20 1","key":"2024050310482564300_b18","first-page":"bcr2013008925","article-title":"Adrenal myelolipoma\u2019s connection with adenoma in the same adrenal gland","volume":"2013","author":"Gurbuz","year":"2013","journal-title":"Case Reports"},{"key":"2024050310482564300_b19","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1016\/j.endonu.2013.04.002","article-title":"Myelolipoma associated with adrenocortical adenoma: an unusual cause of Cushing\u2019s syndrome","volume":"61","author":"Corpas Jim\u00e9nez","year":"2014","journal-title":"Endocrinolog\u00eda y Nutrici\u00f3n"},{"key":"2024050310482564300_b20","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1080\/08998280.2003.11927882","article-title":"Evaluation and management of the incidental adrenal mass","volume":"16","author":"Arnold","year":"2003","journal-title":"Baylor University Medical Center Proceedings"},{"key":"2024050310482564300_b21","article-title":"The incidentally discovered adrenal mass","volume":"356","author":"Pacak","year":"2007","journal-title":"N Engl J Med"},{"key":"2024050310482564300_b22","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.rcl.2008.01.003","article-title":"Imaging techniques for adrenal lesion characterization","volume":"46","author":"Blake","year":"2008","journal-title":"Radiol Clin North Am"}],"container-title":["The British Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/95\/1129\/20210555\/57395049\/bjr.20210555.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/95\/1129\/20210555\/57395049\/bjr.20210555.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T10:50:21Z","timestamp":1714733421000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjr\/article\/doi\/10.1259\/bjr.20210555\/7451549"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,18]]},"references-count":22,"journal-issue":{"issue":"1129","published-online":{"date-parts":[[2021,10,18]]},"published-print":{"date-parts":[[2022,1,1]]}},"URL":"https:\/\/doi.org\/10.1259\/bjr.20210555","relation":{},"ISSN":["0007-1285","1748-880X"],"issn-type":[{"value":"0007-1285","type":"print"},{"value":"1748-880X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,1,1]]},"published":{"date-parts":[[2021,10,18]]},"article-number":"20210555"}}