Macroscopic and CT-scan findings in primary pigmented nodular adrenocortical disease (PPNAD) A: Macroscopic appearance of the adrenal gland in PPNAD. The cut surfaces show multiple pigmented micronodules. The periadrenal fat is also visible around the adrenal capsule. B: Adrenal CT-scan in PPNAD. A micronodule is visible on the external part of the left adrenal on the CT-scan shown (see red arrow).