Adrenal cysts

Endothelial cyst
  • Vascular cyst
  • Endothelial lining
  • 45% of adrenal cysts
  • 2/3 in females
  • 8% bilateral
  • May have residual adrenocortical tissue in wall 
Hemorrhagic cyst
  • Pseudocyst
  • 39% of adrenal cysts
  • Middle-aged women 
  • Seen in Beckwith-Wiedemann syndrome
  • Originally would have been an endothelial cyst, that underwent hemorrhage, and secondary fibrosis or hemosiderin deposition
Parasitic cyst
  • Echinococcal
  • Asymptomatic
  • Imaging types:
    1. Simple cysts with no internal architecture
    2. Water lily sign with separation of membrane layers
    3. Complex internal septa and floating debris
    4. Solid walls and calcification +
    5. Solid walls and calcification +++
Epithelial lined cyst
  • True cyst
  • Rare
  • Mesothelial origin
  • Retention cysts, embryonal cysts or arise from adenomas
Lymphangioma 
  • Rare
  • Thin walled, smooth with flattened endothelial cells