Adrenocorticotropic hormone (ACTH)- independent macronodular adrenal hyperplasia is an infrequent cause of Cushing's syndrome and may be confused with diffuse nodular or bilateral macro nodular hyperplasia (AIMAH) resulting from chronic stimulation by ACTH in Cushing's disease or ectopic ACTH secretion. On Computed tomography (CT) scan adrenal glands can be massively enlarged and bilateral nodules of soft tissue density measuring up to 5 cm distorting normal adrenal glands. Here we have a case of AIMAH in which CT scan revealed massively enlarged bilateral adrenal glands with multiple nodules giving an appearance of ‘bunch of grapes’.
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