EUS-guided FNA of the left adrenal gland in patients with thoracic or GI malignancies

Eloubeidi, Mohamad A.; Seewald, Stefan; Tamhane, Ashutosh; Brand, Boris; Chen, Victor K.; Yasuda, Ichiro; Cerfolio, Robert J.; Omar, Salem; Topalidis, Theodoros; Wilcox, C. Mel; Soehendra, Nib

doi:10.1016/s0016-5107(04)00296-2

Cited by 96 publications

(92 citation statements)

References 26 publications

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“…The results from this study showing 92% sensitivity and 93% accuracy for PNB of hilar lesions are comparable to the sensitivity and accuracy rates of EUS-guided FNAB (92%-97%) and endobronchial ultrasound-guided FNAB (92%-98%). 22,[30][31][32][33][34] The reported complication rates associated with EUS-guided and endobronchial ultrasound-guided FNAB are very low overall, and complications relating to pneumothorax and thoracostomy tube placement have not been encountered for sampling of mediastinal and hilar lesions. 35,36 When endobronchial ultrasound-guided FNAB is used for sampling of peripheral lung lesions, the reported pneumothorax rate can be up to 8%.…”

Section: Discussionmentioning

confidence: 99%

Accuracy and sensitivity of computed tomography‐guided percutaneous needle biopsy of pulmonary hilar lymph nodes

Avritscher

Krishnamurthy

Ensor

et al. 2010

Cancer

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BACKGROUND: Because of their proximity to the pulmonary artery or vein, hilar lymph nodes are routinely biopsied with endobronchial or endoscopic ultrasonography (EUS)-guided fine-needle aspiration biopsy (FNAB). Computed tomography (CT)-guided percutaneous needle biopsy (PNB) allows the operator to acquire a larger core needle biopsy (CNB) when initial samples are inconclusive, when the suspected disease is not optimally diagnosed with FNAB, or when biomarkers are required. The purpose of this study was to retrospectively evaluate the sensitivity and accuracy of CT-guided PNB in patients with hilar adenopathy. METHODS: The authors identified 80 patients who underwent 81 CT-guided PNBs of pulmonary hilar lesions from October 2002 through December 2006 and retrospectively reviewed their medical and imaging records. The PNB sensitivity and accuracy were calculated in each case, and each case was reviewed for complications, including pneumothorax and subsequent thoracostomy tube insertion. RESULTS: PNB included FNAB and CNB in 81 (100%) and 14 (17%) procedures, respectively. Data on 69 PNB specimens (67 FNAB specimens and 13 CNB specimens) were available for statistical analysis. Overall, PNB had a sensitivity of 91.4% (95% confidence interval [CI], 81.0%-97.1%) and an accuracy rate of 92.8% (95% CI, 83.9%-97.1%). Pneumothoraxes occurred in 39 patients (48%), 26 (32%) of whom required thoracostomy tube insertion. CONCLU-SIONS: CT-guided PNB of pulmonary hilar lesions has high sensitivity and accuracy and represents a viable alternative for endobronchial ultrasound-or EUS-guided FNAB when larger biopsy samples are required for diagnosis or biomarker analysis. However, the procedure can result in high rates of pneumothorax.

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Section: Discussionmentioning

confidence: 99%

Accuracy and sensitivity of computed tomography‐guided percutaneous needle biopsy of pulmonary hilar lymph nodes

Avritscher

Krishnamurthy

Ensor

et al. 2010

Cancer

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“…[1][2][3]21 A relatively new imaging modality that allows both detailed imaging as well as FNA of both adrenals (especially the left one) and neutralizes the above difficulties is endoscopic ultrasound (EUS)-FNA. [133][134][135][136][137][138] It may even detect small lesions not visible on transabdominal imaging because of the proximity of the ultrasound transducer to the adrenal gland. As a result of this, organs that are usually traversed with a percutaneous approach are avoided.…”

Section: Fine-needle Aspiration (Fna) Biopsymentioning

confidence: 99%

“…EUS has been shown to be superior to transabdominal US in visualising the left adrenal gland, with a detection rate of 98% as compared to 69% for transabdominal US 135 and an accuracy of about 83%. 138 EUS-FNA biopsy is considered to be safe and major complications after EUS-FNA biopsy of deep-seated lesions are rare. Most of the adverse events observed are similar to those associated with endoscopy.…”

Section: Fine-needle Aspiration (Fna) Biopsymentioning

confidence: 99%

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Adrenal incidentaloma: a diagnostic challenge

Anagnostis¹,

Karagiannis²,

Τζιόμαλος³

et al. 2009

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The widespread application of abdominal imaging procedures has resulted in an increased frequency of clinically silent adrenal masses. Adrenal incidentaloma (AI) is a term applied to an accidentally discovered adrenal mass on imaging performed for the investigation of an unrelated complaint. Adrenal incidentalomas (AIs) are a cluster of different pathologies, the majority of which are benign and non-functioning adrenal adenomas. However, mild hormonal alterations as well as metabolic abnormalities may be present in patients with AIs. Thus, a multidisciplinary approach with biochemical and radiologic evaluation is needed to characterize these lesions and identify patients who are at high risk for hormonal or malignant evolution. Significant new information has helped resolve controversies regarding the most reliable approach to this clinical problem. The present review considers the prevalence, pathology and natural history of AIs. We also discuss the reliability of available screening methods and localization techniques and consider optimal management and follow-up strategies.

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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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EUS-guided FNA of the left adrenal gland in patients with thoracic or GI malignancies

Cited by 96 publications

References 26 publications

Accuracy and sensitivity of computed tomography‐guided percutaneous needle biopsy of pulmonary hilar lymph nodes

Accuracy and sensitivity of computed tomography‐guided percutaneous needle biopsy of pulmonary hilar lymph nodes

Adrenal incidentaloma: a diagnostic challenge

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

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