A number of conditions can explain calcifications in the adrenal gland identified on imaging studies.


Differential diagnosis of adrenal calcifications:

(1) adrenal hemorrhage (trauma, anticoagulation, thrombosis, fetal anoxia, etc)

(2) granulomatous inflammation (tuberculosis, histoplasmosis, etc)

(3) benign adrenal cyst(s)

(4) hemangioma

(5) myelolipoma

(6) Wolman's disease

(7) metastatic carcinoma

(8) pheochromocytoma

(9) mature teratoma arising in the adrenal gland (rare)

(10) neuroblastoma

(11) adrenal cortical carcinoma

(12) familial Mediterranean fever


Initial workup:

(1) age of the patient

(2) clinical status (healthy vs ill)

(3) family history

(4) history of malignancy

(5) history of mycobacterial or deep fungal infection

(6) history of trauma

(7) determine imaging features (unilateral vs bilateral, localized vs diffuse, etc)


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