Copyright 2012
Definition
Pheochromocytoma Neovascularity |
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The angiogram of the right inferior adrenal artery shows mass that is characterised by hypervascularity and neovascularity (a). Image b is a magnified view of the inferior part of the mass that highlights the neovascularity that is characterized by vessels that have a non geometric pattern with vessels branching in odd directions and non progressive change in size, unlike the tree like branching that occurs in normal structures. This mass was diagnosed as a pheochromocytoma. Angiography is not safely performed in patients with pheochromocytoma since a crisis can be precipitated by the contrast. This case originates from an era prior to sophisticated imaging and biochemical evaluation Copyright 2012 Courtesy Ashley Davidoff MD 26500cL.8 |
Hypovascular Mass with Splayed Vessels Adrenal Adenocarcinoma |
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Image (a) reveals a large mass in the region of the left adrenal with scattered dystrophic calcification. The angiogram of the left superior adrenal artery shows a relatively hypovascular mass wit arterioles splayed around the mass which was subsequently shown to be a primary adenocarcinoma of the adrenal Copyright 2012 Courtesy Ashley Davidoff MD 26821cLb.8 |
Arteriovenous Shunting in a Pheochromocytoma |
| The aortogram of the right kidney in the arterial phase (a,b) and nephrogram phase (c,d) reveals a hypervascular mass arising from the right adrenal gland overlaid in green (b and d). The salmon pink arrow in b shows the renal artery in the arterial phase and the diffuse homogeneous enhancement in the parenchymal or nephrogram phase is shown by the maroon arrow in d. The suprarenal mass shows different perfusional characteristics that typify arteriovenous shunting in the mass. In the arterial phase (a,b) the arterial supply (bright red) shows bizarre angulation, non uniform branching with early draining veins (blue) seen while the kidney is still in the arterial phase. The veins become more prominent while the renal vein of the kidney is yet to materialize. The mass was shown pathologically to be a pheochromocytoma. Angiography is not safely performed in patients with pheochromocytoma since a crisis can be precipitated by the contrast. This case originates from an era prior to sophisticated imaging and biochemical evaluation.
Copyright 2012 Courtesy Ashley Davidoff MD 26986cL02.9 |