Table 2

Clinical, biochemical and radiological features of adrenal Cushing

			Primary adrenocortical hyperplasia
			Macronodular hyperplasia		Micronodular hyperplasia
	Adrenocortical adenoma	Adrenocortical carcinoma	BMAH	c-BMAH	PPNAD	MAD
Frequency	∼55%	∼35%	Estimated 10%
Age	All ages	All ages; familial cases in childhood	Fifth to sixth decade	Early childhood	Childhood or early adulthood
Clinical presentation	Mild-to-severe Cushing	Moderate-to-severe Cushing with rapid onset and possible virilisation	Mild Cushing with insidious onset	Moderate-to-severe Cushing	Moderate-to-severe Cushing
Biochemical features	Negative Liddle's test	Negative Liddle's test	Negative Liddle's test	Negative Liddle's test	Paradoxical cortisol response in Liddle's test	Negative Liddle's test
Radiological features	Solitary mass, often <4 cm, defined margins, homogeneous, <10 HFU, absolute washout >60%	Solitary mass, often >4 cm, irregular margins, heterogenous, >10 HFU, absolute washout <60%	Marked bilateral adrenal enlargement with multiple large non-pigmented nodules (1–5 cm)		Normal or small size adrenal glands with occasional small nodules (<1 cm)

BMAH, primary bilateral macronodular adrenocortical hyperplasia; c-BMAH, childhood BMAH; HFU, Hounsfield unit; MAD, non-pigmented micronodular adrenocortical disease; PPNAD, primary pigmented nodular adrenocortical disease.