Figure 3a. Adenoma within a myelolipoma in a 44-year-old woman with Cushing syndrome. (a) Longitudinal ultrasonographic image shows a hyperechoic suprarenal mass (arrow) with an appearance consistent with that of a predominantly fat-containing lesion. (b) Unenhanced CT scan helps confirm the fatty nature of the mass (arrow). However, a relatively large soft-tissue component (*) can also be seen within the lesion. (c) Coronal spin-echo T1-weighted MR images (740/25) show a predominantly fat-containing high-signal-intensity mass (short arrows) with areas of intermediate signal intensity (long arrow). (d) Axial short inversion time inversion-recovery MR image (1,800/25, inversion time msec = 100) shows a large mass with marked signal dropout (arrow), a finding that confirms the predominantly fatty nature of the lesion. At histologic analysis, the lesion proved to be a myelolipoma containing an adenoma.