adrenal glands Flashcards
which is true about the size of the adrenal glands in dogs?
a) it varies with body weight
b) Labrador retrievers tend to have smaller adrenals than expected for their body weight
c) adrenal length is the best standardised measurement on ultrasound
A is true
Labradors have larger adrenal glands- paper from 2013- caudal pole measured in a longitudinal plane: 7.9 mm (left) and 9.5 mm (right) for the Labrador retrievers and 5.4 mm (left) and 6.7 mm (right) for the Yorkshire terriers
width of the caudal pole used
what is the upper reference for adrenal gland size in cats less than 4kg
a) 3mm
b) 3.9mm
c) 4.5mm
d) 4.8mm
B with upper range of 4.1mm
which of the following is false in relation to the adrenal glands of dogs and cats?
a) in older cats, the adrenal glands may be mineralised as an incidental finding
b) adrenal dependent hyperadrenocorticism is the most common form of cushings in dogs
c) adrenomegaly is not specific to adrenal endocrine disease
d) in dogs previously treated with steroids, the adrenal glands should return to normal size within 1 month of cessation of therapy
e) in dogs with adrenal dependent cushings the adrenal may be normal, asymmetrically enlarged, or contain a nodule
f) in cats the adrenals may be enlarged with hyperthyroidism
B is false- pituitary dependent is most common (80%).
adrenomegaly can be seen with chronic disease
e- sometimes a mass is also seen on the other adrenal or in the pituitary, making it hard to assess
f- they can also enlarge with hyperaldosteronism and hyperprogesteronism
an adrenal gland smaller than X in dogs is supportive of addisons?
a) 4.1 mm
b) 5.0 mm
c) 3.4 mm
d) 3.8 mm
c- or if you can’t see it at all despite adequate assessment.
6 differentials for adrenal nodules/ masses
includes cortical adenoma,
cortical adenocarcinoma, pheochromocytoma, myelolipoma, metastasis, and hyperplasia. Cortical tumors may or may not be functional.
can be found incidentally- Reported diagnoses include normal tissue, nonfunctional cortical tumors, granulomas,
adrenal cysts, myelolipoma, hemorrhage, metastatic tumor, and pheochromocytoma
EMH
solid adrenal lesions more than 2cm predict…
a) hyperplasia
b) malignant neoplasia
c) benign neoplasia
d) benign or malignant neoplasia
D
Yet, both benign neoplasms and hyperplasia may produce quite large lesions. The most reliable sign of malignancy is evidence of invasion of local tissues and vessels, which can occur with adrenocortical carcinomas and pheochromocytomas. can also extend in to other regional tissues- muscle, vertebrae, kidney
solid adrenal lesions more than 4cm predict…
a) hyperplasia
b) malignant neoplasia
c) benign neoplasia
d) benign or malignant neoplasia
B
The presence of a venous thrombus adjacent to an adrenal mass is also highly suggestive of malignancy.
two differentials for non- adrenal, non renal retroperitoneal neoplasia
paraganglioma, haemangiosarcoma, vertebral mass, lipoma, liposarcoma
which of the following is false regarding adrenal glands:
a) Discrete, well-defined hyperechoic nodules suggest benign neoplasia
b) adrenomegaly with overall normal shape is more suggestive of hyperplasia
c) adrenomegaly >2cm and an adjacent venous thrombus is suggestive of malignancy
d) calcification and adrenomegaly in dogs is specific for malignancy
D. could still be benign eg adenoma
amorphous, irregularly shaped and inhomogeneous masses suggest malignancy.
what is the normal range for adrenal gland measurement in dogs? (width)
6-8mm, smaller in small dogs, bigger in big dogs
Which ultrasonographic finding is most suggestive of an adrenal cortical tumour?
A) Bilateral adrenal enlargement
B) A single, well-defined nodule >2 cm
C) Hyperechoic adrenal cortex
D) Uniformly hypoechoic glands
B
In a dog with hyperadrenocorticism caused by an adrenal tumour, what is the expected sonographic appearance of the contralateral adrenal gland?
A) Normal size with heterogeneous echotexture
B) Enlarged with hyperechoic nodules
C) Small (<5 mm) due to suppression
D) Mineralised with shadowing artifacts
C
Which adrenal tumour is most commonly associated with systemic hypertension?
A) Adrenocortical adenoma
B) Adrenocortical carcinoma
C) Pheochromocytoma
D) Myelolipoma
C
