Bilateral adrenal gland enlargement

Bilateral adrenal gland enlargement

The differential for bilaterally enlarged adrenal glands is relatively limited:

• adrenal hyperplasia
  • micronodular adrenal hyperplasia
  • macronodular adrenal hyperplasia
    • adrenocorticotropin (ACTH)-independent macronodular adrenocortical hyperplasia (AIMAH) 
• adrenal metastases
• adrenal hemorrhage
• adrenal involvement with granulomatous diseases
  • adrenal histoplasmosis 
• adrenal lymphoma
• primary pigmented nodular adrenal dysplasia (PPNAD): usually the glands are normal in size, but nodular; in older patients they may be enlarged
• adrenal pheochromocytoma: especially when familial (e.g. in multiple endocrine neoplasia type II)