Yet, APAs that are 3 or 4 mm in diameter may escape detection on CT or a patient with a unilateral APA may have bilateral adrenal nodules on CT - one that is nonfunctional and one that is hypersecreting aldosterone.Īlgorithmic approach to subtype evaluationĪn algorithmic approach to subtype evaluation of a patient with primary aldosteronism.

A patient with IHA may be thought to have an APA because an adrenal nodule was detected on CT - a finding that may be due to the age-related occurrence of nonfunctioning adrenal cortical nodules. Young notes: 'However, because of the prevalence of nonfunctioning cortical adenomas, hormonal hyperfunction cannot be inferred from simply the presence of an adrenal nodule. When body computerized tomography (CT) became available in the late 1970s, it was thought to be a good test to distinguish among the subtypes of PA. Following right laparoscopic adrenalectomy, the hypokalemia resolved and his residual hypertension was easily controlled with two antihypertensive medications. Adrenal venous sampling lateralized aldosterone secretion to the right adrenal gland and a cortical adenoma was found at laparoscopic right adrenalectomy. The scan shows an 11-mm right adrenal nodule (arrow, left panel) and a 9-mm left adrenal nodule (arrow, right panel).

Scan of man with hypokalemia and poorly controlled hypertensionĪdrenal computerized tomographic scan of a 59-year-old man with hypokalemia and poorly controlled hypertension despite taking four antihypertensive drugs.

Adrenal gland location