Cushing syndrome: Diagnostic workup and imaging features, with clinical and pathologic correlation

Research output: Contribution to journalReview articlepeer-review

40 Scopus citations

Abstract

OBJECTIVE. Cushing syndrome (CS) is a constellation of clinical signs and symptoms resulting from chronic exposure to excess cortisol, either exogenous or endogenous. Exogenous CS is most commonly caused by administration of glucocorticoids. Endogenous CS is subdivided into two types: adrenocorticotropic hormone (ACTH) dependent and ACTH independent. CONCLUSION. Cushing disease, which is caused by a pituitary adenoma, is the most common cause of ACTH-dependent CS for which pituitary MRI can be diagnostic, with bilateral inferior petrosal sinus sampling useful in equivocal cases. In ectopic ACTH production, which is usually caused by a tumor in the thorax (e.g., small cell lung carcinoma, bronchial and thymic carcinoids, or medullary thyroid carcinoma) or abdomen (e.g., gastroenteropancreatic neuroendocrine tumors or pheochromocytoma), CT, MRI, and nuclear medicine tests are used for localizing the source of ACTH. In ACTH-independent CS, which is caused by various adrenal abnormalities, adrenal protocol CT or MRI is usually diagnostic.

Original languageEnglish (US)
Pages (from-to)19-32
Number of pages14
JournalAmerican Journal of Roentgenology
Volume209
Issue number1
DOIs
StatePublished - Jul 2017

Keywords

  • Adrenal adenoma
  • Adrenocortical carcinoma
  • Adrenocorticotropic hormone-independent macronodular adrenal hyperplasia
  • Cushing disease
  • Cushing syndrome
  • Pituitary adenoma
  • Primary pigmented nodular adrenal disease

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint

Dive into the research topics of 'Cushing syndrome: Diagnostic workup and imaging features, with clinical and pathologic correlation'. Together they form a unique fingerprint.

Cite this