Synchronous primary pancreatic endocrine neoplasm and adrenal pheochromocytoma diagnosed by EUS-guided FNA

Stelow, Edward B.; Stanley, Michael W.; Mallery, Shawn

doi:10.1016/s0016-5107(03)02350-2

Cited by 4 publications

(4 citation statements)

References 15 publications

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“…234 A possible diagnosis of multiple endocrine neoplasia syndrome or von Hippel-Lindau disease made by EUS-FNA in case of synchronous PEN and pheochromocytoma has been reported. 235 Cytologic preparations are usually moderately cellular to highly cellular. Evaluation of the smears at low magnification often shows various sizes and shapes of cell aggregates recapitulating the architectural organoid or trabecular pattern seen in tissue sections.…”

Section: Pancreatic Endocrine Neoplasmmentioning

confidence: 99%

“…Mitoses and necrosis are seen in some malignant PENs. 234,235 PENs from women show frequent loss of chromosome X, and those of men show loss of chromosome Y and rarely of X. In addition, loss of a sex chromosome is associated with metastasis, local invasion, and poor survival.…”

Section: Pancreatic Endocrine Neoplasmmentioning

confidence: 99%

“…When it presents, it may either be sporadic, the most common, or familial. 235 The tumor is diagnosed based on imaging studies, clinical grounds, and the finding of increased levels of urinary vanillylmandelic acid. Twenty percent are nonfunctional, however.…”

Section: Pheochromocytomamentioning

confidence: 99%

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Review of endoscopic ultrasound‐guided fine‐needle aspiration cytology

Bardales

Stelow

Mallery

et al. 2006

Diagnostic Cytopathology

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This review, based on the Hennepin County Medical Center experience and review of the literature, vastly covers the up-to-date role of endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (FNA) in evaluating tumorous lesions of the gastrointestinal tract and adjacent organs. Emphasis is given to the tumoral and nodal staging of esophageal, pulmonary, and pancreatic cancer. This review also discusses technical, pathological, and gastroenterologic aspects and the role of the pathologist and endosonographer in the evaluation of these lesions, as well as the corresponding FNA cytology and differential diagnosis.

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Section: Pancreatic Endocrine Neoplasmmentioning

confidence: 99%

Section: Pancreatic Endocrine Neoplasmmentioning

confidence: 99%

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Review of endoscopic ultrasound‐guided fine‐needle aspiration cytology

Bardales

Stelow

Mallery

et al. 2006

Diagnostic Cytopathology

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“…Although the cytology of paragangliomas has been well described, significant cytologic overlap can exist between non-neoplastic adrenal medulla and pheochromocytomas, cortical tumors and pheochromocytomas, and metastases and pheochromocytomas. 23,[27][28][29][30] Cell block IHC can obviously sort out some of these difficulties. Separating malignant and benign pheochromocyto- mas is not something that should be attempted with cytology, as it can rarely be accomplished even with histology.…”

Section: Eus-guided Fna Of the Adrenal Glandsmentioning

confidence: 99%

Sampling of the adrenal glands by endoscopic ultrasound-guided fine-needle aspiration

et al. 2005

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Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) has proven to be a valuable modality for the primary diagnosis and staging of gastrointestinal, and perigastrointestinal malignancy. Aside from assessing thoracic and abdominal lymph nodes and the liver for metastases, EUS can assess and sample the adrenal glands, which are frequently involved by metastatic disease, but can also harbor benign primary neoplasms. The cytology files at our institution were reviewed for all cases of EUS-guided FNA of the adrenal glands. Clinical histories, sonographic findings, and cytologic findings of all cases were reviewed. Results were compared with overall EUS-guided FNA performance and the performance of non-EUS-guided FNA of the adrenal. The utility of cell block immunohistochemistry (IHC) in these cases was reviewed. Between 1/1/00 and 5/15/04 there were 24 cases of EUS-guided FNA of the adrenal gland from 22 different patients (13 men; 9 women) at our institution. This represented 1.4% of overall EUS-guided FNA and 77% of adrenal gland FNA. Patient ages ranged from 37 to 86 yr (mean 69 +/- 11 yr). Most patients had other cancers or mass lesions and were being staged at the time of the procedure (19 of 22). Almost all FNAs were of the left adrenal gland (23 of 24). Lesion size ranged from 0.9 to 7.9 cm (mean 2.5 +/- 1.6 cm). Diagnostic material was present in all cases when compared with an overall EUS-guided FNA diagnostic rate of 88%. Material for cell block was present in 21 cases, and IHC was used in 3 cases. Final diagnoses were as follows: cortical tissue consistent with cortical adenoma (19), metastatic adenocarcinoma (3), pheochromocytoma (1), and adrenal cortical carcinoma (1). EUS-guided FNA of the adrenal gland is primarily used in the staging of other malignancies when lesions of the left adrenal are recognized sonographically. Diagnostic tissue is easily obtained, including material for cell block IHC, which allows definitive diagnosis in cases that present difficult differential diagnoses.

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