Non-small cell lung carcinoma adrenal metastases. Computed tomography and percutaneous needle biopsy in their diagnosis.

One hundred seventy-two consecutive patients with non-small cell lung carcinoma underwent adrenal computed tomography (CT) as part of their initial staging evaluation. Twenty of these patients (12%) had either unilateral or bilateral adrenal masses detected by CT. Six of these 20 patients had distant metastases at other sites and the adrenal masses were presumed to be metastases. Fourteen of the 20 patients, without other evidence of distant metastases at the time of CT, underwent percutaneous 22-gauge needle biopsy of the adrenal masses. The results of the biopsies diagnosed lung carcinoma metastases in 13 patients and a primary adrenal tumor in 1 patient. An additional 32 patients with normal adrenal glands by CT criteria underwent percutaneous 22-gauge needle biopsy of their morphologically normal glands. In four of these patients (12%), the results of CT-guided biopsy diagnosed lung carcinoma metastases. The role of CT and percutaneous needle biopsy in diagnosing non-small cell lung carcinoma metastases to the adrenal glands is discussed.