EUS-FNA of the left adrenal gland-diagnostic yield and complications

Seewald, Stefan; Omar, Salem; Dy, Frederick; Soehendra, Nib

doi:10.1055/s-2006-947775

Cited by 9 publications

(15 citation statements)

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“…3 Endoscopic ultrasound (EUS) overcomes these limitations due to proximity to target structures (adrenals), is safe and easy to perform in the experienced hands and has good diagnostic accuracy. [4][5][6][7][8][9][10][11] In this paper, we report ten cases of adrenal histoplasmosis diagnosed by EUS-guided FNA.…”

Section: Introductionmentioning

confidence: 99%

Adrenal histoplasmosis diagnosed by endoscopic ultrasound guided fine needle aspiration: experience of 10 patients

Singh¹

2017

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Background:There have been sporadic reports of histoplasmosis from India. Although traditionally considered a disease of immunocompromised hosts, immunocompetent patients presenting with adrenal histoplasmosis have been reported. Endoscopic ultrasound (EUS) provides easy and safe approach to adrenal glands for fine needle aspiration. Methods: We report 10 cases of adrenal histoplasmosis diagnosed by endoscopic ultrasound (EUS) guided FNA. The mean age at diagnosis was 54 ± 9 years, all were males. Eight patients were immunocompetent while two had cirrhosis; none of them was retrovirus positive. All patients presented with fever and weight loss, 8 had bilateral adrenal enlargement while 2 had isolated left adrenal enlargement. EUS features included hypoechoic (30%) or heteroechoic (70%) adrenal glands, presence of hypoechoic areas suggestive of necrosis within the gland was identified in 40% of these patients. Adrenal insufficiency was present in 1 patient (10%) which persisted even after successful treatment. Conclusion: Adrenal histoplasmosis should be considered even in immunocompetent hosts presenting with constitutional symptoms and adrenal enlargement. EUS guided FNA is a safe and accurate modality for adrenal sampling.

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Section: Introductionmentioning

confidence: 99%

Adrenal histoplasmosis diagnosed by endoscopic ultrasound guided fine needle aspiration: experience of 10 patients

Singh¹

2017

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“…Transesophageal ultrasound guided fine needle aspiration (EUS-FNA) is a safe and minimally invasive alternative for surgical mediastinal staging that is incorporated in international guidelines [20,21]. Reports about EUS-FNA for the assessment of left adrenal metastases in patients with lung cancer are limited, mostly single centre case series and rarely take PET findings into account [19,[22][23][24][25][26][27]. The aim of this multicentre study was to investigate the sensitivity of EUS-FNA in patients with (suspected) lung cancer with a suspect left adrenal gland metastasis based on CT and/or 18 FDG-PET imaging.…”

Section: Introductionmentioning

confidence: 99%

EUS-FNA for the detection of left adrenal metastasis in patients with lung cancer

et al. 2011

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“…Other studies evaluating adrenal gland EUS-FNA and its clinical impact in patients with established or suspected malignancy, have either used survival at ≥ 2 years as confirmation for benignancy or not reported follow-up for benign lesions [4,12,21] . Schuurbiers et al [17] reported follow-up imaging for 10/30 patients with either benign or nondiagnostic EUS-FNA of the left adrenal gland.…”

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

Martínez

Leblanc

Al‐Haddad

et al. 2014

WJN

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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 caseseries, 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, followup 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.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Adrenal gland neoplasms/diagnosis; Adrenal glands/pathology; Adrenal gland/ultrasonography; Adrenal gland neoplasms/secondary; Endosonography; Biopsy; Fine-needle Core tip: Studies evaluating endoscopic ultrasound fine-needle aspiration (EUS-FNA) of the adrenal gland generally include patients with underlying malignancy only and most lack follow-up for benign lesions. We report the clinical utility of adrenal gland EUS-FNA in a retrospective study that included 94 patients who underwent EUS-FNA of either adrenal for various indications and provide follow-up information for those with benign EUS-FNA cytology results. 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%, without

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EUS-FNA of the left adrenal gland-diagnostic yield and complications

Cited by 9 publications

References 0 publications

Adrenal histoplasmosis diagnosed by endoscopic ultrasound guided fine needle aspiration: experience of 10 patients

Adrenal histoplasmosis diagnosed by endoscopic ultrasound guided fine needle aspiration: experience of 10 patients

EUS-FNA for the detection of left adrenal metastasis in patients with lung cancer

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

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