Abdominal and GI imaging: phaeochromocytoma on MRI: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Abdominal and GI imaging: phaeochromocytoma on MRI

Sample item

A 38-year-old with paroxysmal headache, sweating and hypertension has a 4 cm adrenal mass. MRI shows marked T2 hyperintensity, and the mass does not lose signal on out-of-phase imaging. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Phaeochromocytoma

Phaeochromocytomas are vascular, T2-bright tumours that lack intracellular lipid, so there is no signal drop on chemical shift imaging. Biochemistry and MIBG or DOTATATE scans confirm the diagnosis and the syndrome points to it.

Option by option

  • A. Adrenal cortical carcinoma

    Cortical carcinoma is a large heterogeneous mass with necrosis, usually with hormonal excess other than catecholamines.

  • B. Phaeochromocytoma (correct)

    Correct. A very T2-bright, lipid-poor adrenal mass in a patient with catecholamine symptoms is a phaeochromocytoma.

  • C. Myelolipoma

    A myelolipoma contains macroscopic fat and shows signal loss on fat suppression.

  • D. Lipid-rich adenoma

    A lipid-rich adenoma loses signal on out-of-phase images and is non-functional or cortisol-secreting.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Phaeochromocytoma. Phaeochromocytomas are vascular, T2-bright tumours that lack intracellular lipid, so there is no signal drop on chemical shift imaging.

Why is "Adrenal cortical carcinoma" not the answer?

Cortical carcinoma is a large heterogeneous mass with necrosis, usually with hormonal excess other than catecholamines.

Why is "Myelolipoma" not the answer?

A myelolipoma contains macroscopic fat and shows signal loss on fat suppression.

Why is "Lipid-rich adenoma" not the answer?

A lipid-rich adenoma loses signal on out-of-phase images and is non-functional or cortisol-secreting.

What concept does this question test?

It tests Abdominal and GI imaging: phaeochromocytoma on MRI in Radiology. Biochemistry and MIBG or DOTATATE scans confirm the diagnosis and the syndrome points to it.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Abdominal and GI imaging: phaeochromocytoma on MRI?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.