Wadih G E, Nance K V, Silverman J F
Department of Pathology and Laboratory Medicine, East Carolina University School of Medicine, Greenville, NC 27858-4354.
Arch Pathol Lab Med. 1992 Aug;116(8):841-6.
Fine-needle aspiration biopsy of 50 adrenal masses from 48 patients was performed between 1984 and 1991. The series consisted of 28 males and 20 females, with an age range of 12 months to 79 years (mean age, 55 years). Clinical and/or pathologic follow-up was available in 37 patients. Fine-needle aspiration was diagnostic in all 29 malignant cases having follow-up, with no false-positive diagnoses. There were six primary malignancies (three neuroblastomas, two pheochromocytomas, and one adrenal cortical carcinoma) and 23 metastatic lesions. Of these, the lung was the most frequent primary malignancy (60%), followed by melanoma and renal cell carcinoma (8.6% each). The remaining nonmalignant fine-needle aspiration diagnoses were adrenal cortical neoplasms (most likely adenoma), adrenal cortical hyperplasia, myelolipoma, benign adrenal tissue, and abscess. Based on clinical follow-up, three other adrenal adenomas were not diagnosed by fine-needle aspiration. Six biopsy specimens (12%) were insufficient for diagnosis. Ancillary studies including electron microscopy and/or immunocytochemistry were performed on 13 malignant aspirates and provided additional confirmation of the cytology diagnosis in 12 cases. This study confirms that fine-needle aspiration is a sensitive and highly specific procedure for the evaluation of primary and metastatic malignancies involving the adrenal gland. The technique is less useful in the workup of benign processes but, in some instances, can provide specific diagnostic information.
1984年至1991年间，对48例患者的50个肾上腺肿块进行了细针穿刺活检。该系列包括28名男性和20名女性，年龄范围为12个月至79岁（平均年龄55岁）。37例患者有临床和/或病理随访资料。在所有29例有随访的恶性病例中，细针穿刺均具有诊断价值，无假阳性诊断。有6例原发性恶性肿瘤（3例神经母细胞瘤、2例嗜铬细胞瘤和1例肾上腺皮质癌）和23例转移瘤。其中，肺部是最常见的原发性恶性肿瘤（60%），其次是黑色素瘤和肾细胞癌（各占8.6%）。其余非恶性细针穿刺诊断为肾上腺皮质肿瘤（最可能为腺瘤）、肾上腺皮质增生、髓脂肪瘤、良性肾上腺组织和脓肿。根据临床随访，另外3例肾上腺腺瘤未通过细针穿刺诊断出来。6份活检标本（12%）诊断不足。对13份恶性穿刺物进行了包括电子显微镜检查和/或免疫细胞化学在内的辅助研究，其中12例进一步证实了细胞学诊断。本研究证实，细针穿刺是评估累及肾上腺的原发性和转移性恶性肿瘤的一种敏感且高度特异的方法。该技术在良性病变的检查中作用较小，但在某些情况下可提供特异性诊断信息。
