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OBJECTIVE Adrenalcysticlymphangiomas(ACL)arerare,benignvasculartumorsandlikelytoimitateotheradrenalcysticlesions inCTimage.ThisstudyaimsataretrospectiveanalysisoftheCTappearanceandclinicaldatawithallpathologicallydiagnosed adrenalmassesinourinstituteandsystematicreviewofallpreviousACLreports. METHOD Inthisstudy,allthepatientswithadrenalmassesunderwentsurgeryorpathologicalexaminationwerecollectedfrom January2011toMay2016inourhospital.AsystematicreviewofACLreportswasperformedbysearchingelectronicdatabases(PubMed,MEDLINE,CochraneLibraryandGoogleScholar)priortoMay2016withEnglishlanguage.Allavailablyprimitivedata ofthecasereportswasincludedandanalyzed. RESULTIntotal1435casesofadrenalmasswiththepathologicalresultsinourhospital,ACLwerediagnosedin9caseswith incidencerateof0.6%(Amongthem,asymptomaticcasesof6,hypertensionof2,apatientwithpersistentleftflankpain).All performedthetotaladrenalectomy.Basedonour9casesand60casesfromthesystematicreview,theaverageageoftheACL patientswere40.3yearsold(rangefrom5to79yearsold,male/femalewith26/43).The34.8%patients(24/69)showed asymptomatic.Theincidencesofabdominalpain,hypertensionandflankpainwereof17.4%,15.9%and13.0%,respectively.All patientshadnoevidenceofrecurrencebyfollowup.Ongrossandmicroscopicpathology,thelesionswerecomposedofdilated cysticspacescontainingserousfluidandlinedbyflattenedendothelialcells.Calcificationwasnotedin33patients(47.8%,33/69). OnunenhancedCTimages,allcasesofACLwerewell-circumscribedandovallesionswithlow-attenuationinternalcontents.On enhancedCTimages,nomeasurablecontrastenhancementwasseenintheselesions. CONCLUSION Whileanasymptomaticadultwiththebigcysticadrenalmass,thediagnosisofACLshouldbeconsidered.The ACLcharacteristicsofCTmanifestationwerethewell-definedcysticlesionwiththepartialcalcificationsandnonenhancement pattern.