Adrenal imaging: adenoma: 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.

Try it

Radiology · Adrenal imaging: adenoma

Sample item

An incidental 2 cm adrenal nodule has an unenhanced attenuation of 5 HU on CT. What does this suggest?

APheochromocytomaBMetastasisCLipid-rich benign adenomaDAdrenocortical carcinoma

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

The answer and the reasoning

C. Lipid-rich benign adenoma

An unenhanced attenuation of 10 HU or less indicates intracellular lipid and a benign adenoma with high specificity. Adenomas also show rapid washout of contrast. Pheochromocytomas are usually bright on T2 and typically above 10 HU.

Option by option

A. Pheochromocytoma
Pheochromocytoma has a higher attenuation and bright T2 signal.
B. Metastasis
Metastases are solid and above 10 HU.
C. Lipid-rich benign adenoma (correct)
Correct. 10 HU or less on a non-contrast scan indicates a lipid-rich adenoma.
D. Adrenocortical carcinoma
Carcinoma is large, heterogeneous and above 10 HU.

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.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Lipid-rich benign adenoma. An unenhanced attenuation of 10 HU or less indicates intracellular lipid and a benign adenoma with high specificity.

Why is "Pheochromocytoma" not the answer?

Pheochromocytoma has a higher attenuation and bright T2 signal.

Why is "Metastasis" not the answer?

Metastases are solid and above 10 HU.

Why is "Adrenocortical carcinoma" not the answer?

Carcinoma is large, heterogeneous and above 10 HU.

What concept does this question test?

It tests Adrenal imaging: adenoma in Radiology. Adenomas also show rapid washout of contrast. Pheochromocytomas are usually bright on T2 and typically above 10 HU.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Adrenal imaging: adenoma?

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.