Puri Rajesh, Thandassery Ragesh Babu, Choudhary Narendra S, Kotecha Hardik, Misra Smruti Ranjan, Bhagat Suraj, Paliwal Manish, Madan Kaushal, Saraf Neeraj, Sarin Haimanti, Guleria Mridula, Sud Randhir
Department of Gastroenterology, Medanta Institute of Digestive & Hepatobiliary Sciences, Medanta, India.
Department of Cytopathology, Medanta The Medicity, Gurgaon, India.
Clin Endosc. 2015 Mar;48(2):165-70. doi: 10.5946/ce.2015.48.2.165. Epub 2015 Mar 27.
BACKGROUND/AIMS: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytology of adrenal masses helps in etiological diagnosis. The aim of this study was to evaluate the diagnostic yield of EUS-FNA of adrenal masses in cases where other imaging methods failed and/or were not feasible.
Twenty-one consecutive patients with adrenal masses, in whom adrenal FNA was performed because conventional imaging modalities failed and/or were not feasible, were prospectively evaluated over a period of 3 years.
Of the 21 patients (mean age, 56±12.2 years; male:female ratio, 2:1), 12 had pyrexia of unknown origin and the other nine underwent evaluation for metastasis. The median lesion size was 2.4×1.6 cm. Ten patients were diagnosed with tuberculosis (shown by the presence of caseating granulomas [n=10] and acid-fast bacilli [n=4]). Two patients had EUS-FNA results suggestive of histoplasmosis. The other patients had metastatic lung carcinoma (n=6), hepatocellular carcinoma (n=1), and adrenal lipoma (n=1) and adrenal myelolipoma (n=1). EUS results were not suggestive of any particular etiology. No procedure-related adverse events occurred.
EUS-FNA is a safe and effective method for evaluating adrenal masses, and it yields diagnosis in cases where tissue diagnosis is impossible or has failed using conventional imaging modalities.
背景/目的：肾上腺肿块的超声内镜引导下细针穿刺抽吸（EUS-FNA）细胞学检查有助于病因诊断。本研究的目的是评估在其他影像学方法失败和/或不可行的情况下，EUS-FNA对肾上腺肿块的诊断率。
连续21例肾上腺肿块患者，因传统影像学检查失败和/或不可行而进行肾上腺细针穿刺，在3年的时间里进行前瞻性评估。
21例患者（平均年龄56±12.2岁；男女比例为2:1），12例有不明原因发热，另外9例接受转移瘤评估。病变的中位大小为2.4×1.6cm。10例患者诊断为结核病（有干酪样肉芽肿[n=10]和抗酸杆菌[n=4]）。2例患者EUS-FNA结果提示组织胞浆菌病。其他患者有转移性肺癌（n=6）、肝细胞癌（n=1）、肾上腺脂肪瘤（n=1）和肾上腺髓样脂肪瘤（n=1）。EUS结果未提示任何特定病因。未发生与操作相关的不良事件。
EUS-FNA是评估肾上腺肿块的一种安全有效的方法，在传统影像学方法无法进行组织诊断或诊断失败的情况下，它能做出诊断。
