A form of bilateral adrenocortical hyperplasia that is often associated with adrenocorticotrophin hormone (ACTH) independent Cushing syndrome and is characterized by small to normal sized adrenal glands containing multiple small cortical pigmented nodules (less than 1 cm in diameter). The disease is primary pigmented nodular adrenocortical disease (MONDO_0015999). Also known as: PPNAD, pigmented nodular adrenocortical disease, pigmented nodular adrenocortical disease, primary, primary pigmented nodular adrenal dysplasia.