Role of endoscopic ultrasound fine-needle aspiration evaluating adrenal gland enlargement or mass.

Content Provider	Europe PMC
Author	Martinez, Melissa LeBlanc, Julia Al-Haddad, Mohammad Sherman, Stuart DeWitt, John
Copyright Year	2014
Abstract	AIM: To report the clinical impact of adrenal endoscopic ultrasound fine-needle aspiration (EUS-FNA) in the evaluation of patients with adrenal gland enlargement or mass. METHODS: In a retrospective single-center case-series, patients undergoing EUS-FNA of either adrenal gland from 1997-2011 in our tertiary care center were included. Medical records were reviewed and results of EUS, cytology, adrenal size change on follow-up imaging ≥ 6 mo after EUS and any repeat EUS or surgery were abstracted. A lesion was considered benign if: (1) EUS-FNA cytology was benign and the lesion remained < 1 cm from its original size on follow-up computed tomography (CT), magnetic resonance imaging or repeat EUS ≥ 6 mo after EUS-FNA; or (2) subsequent adrenalectomy and surgical pathology was benign. RESULTS: Ninety-four patients had left (n = 90) and/or right (n = 5) adrenal EUS-FNA without adverse events. EUS indications included: cancer staging or suspected recurrence (n = 31), pancreatic (n = 20), mediastinal (n = 10), adrenal (n = 7), lung (n = 7) mass or other indication (n = 19). Diagnoses after adrenal EUS-FNA included metastatic lung (n = 10), esophageal (n= 5), colon (n = 2), or other cancer (n = 8); benign primary adrenal mass or benign tissue (n = 60); or was non-diagnostic (n = 9). Available follow-up confirmed a benign lesion in 5/9 non-diagnostic aspirates and 32/60 benign aspirates. Four of the 60 benign aspirates were later confirmed as malignant by repeat biopsy, follow-up CT, or adrenalectomy. Adrenal EUS-FNA diagnosed metastatic cancer in 24, and ruled out metastasis in 10 patients. For the diagnosis of malignancy, EUS-FNA of either adrenal had sensitivity, specificity, positive predictive value and negative predictive value of 86%, 97%, 96% and 89%, respectively. CONCLUSION: Adrenal gland EUS-FNA is safe, minimally invasive and a sensitive technique with significant impact in the management of adrenal gland mass or enlargement.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC4202496&blobtype=pdf
Volume Number	3
DOI	10.5527/wjn.v3.i3.92
PubMed Central reference number	PMC4202496
Issue Number	3
PubMed reference number	25332900
Journal	World Journal of Nephrology [World J Nephrol]
e-ISSN	22206124
Language	English
Publisher	Baishideng Publishing Group Inc
Publisher Date	2014-08-01
Access Restriction	Open
Rights License	©2014 Baishideng Publishing Group Inc. All rights reserved.
Subject Keyword	Adrenal gland neoplasms/diagnosis Adrenal glands/pathology Adrenal gland/ultrasonography Adrenal gland neoplasms/secondary Endosonography Biopsy Fine-needle
Content Type	Text
Resource Type	Article
Subject	Nephrology