Adrenal incidentalomas: What is the role of fine needle biopsy?

Abstract

A series of 13 patients with incidental adrenal mass discovered by computed tomography or/and ultrasound is reported. In 5 cases endocrine evaluation and radiological criteria suggested the diagnosis of the mass. In 8 cases we carried out fine needle biopsy (FNB) under ultrasound guidance. FNB confirmed in two cases the presence of metastatic diseases, in one case adrenal adenoma, in other two cases myelolipoma and in one case lymphoma. Surgical exploration was avoided in all cases. In two cases the presence of an asymptomatic adrenal carcinoma and of a giant adenoma, potentially malignant, was demonstrated by FNB. None of the patients underwent surgical exploration as a final diagnostic measure. In conclusion, FNB may represent a useful tool to select the best modalities of treatment.

Bilateral adrenal tumor: causes and clinical features in eighteen cases

“…Malignant lymphoma is a solid tumor often associated with viral infection and immunodeficiency. In recent years, dozens of cases of bilateral adrenal lymphoma have been reported; the primary pathological type is non-Hodgkin diffuse large B cell lymphoma [3][4][5][6][7]. According to the previous literature and our information, the characteristics of bilateral adrenal lymphoma that distinguish it from other causes of adrenal mass may be summarized as follows: 1. greater age at onset and more common in males;…”

Intra-abdominal bleeding with hemorrhagic shock: a case of adrenal myelolipoma and review of literature

“…Interestingly, a smoky appearance with attenuation values around 20-30HU could be found in some area of myelolipoma due to admixture of adipose and hematopoietic cells [2]. If non-invasive studies could not yield definite diagnosis, fine-needle aspiration (FNA) biopsy should be considered [7–9]. Also in cases where expectant management is being considered, FNA can definitively rule out malignancy [9, 10].…”

“…If non-invasive studies could not yield definite diagnosis, fine-needle aspiration (FNA) biopsy should be considered [7–9]. Also in cases where expectant management is being considered, FNA can definitively rule out malignancy [9, 10]. …”

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“…In a series of 48 patients who had undergone FNB for incidentally discovered adrenal masses, 23 showed evidence of metastatic disease to the adrenal. Eighteen of the 23 had known malignancy [54]. The most common primaries (61%) were adrenal metastases from a primary lung carcinoma.…”