Dusenbery D, Dekker A
Department of Pathology, Montefiore University Hospital, University of Pittsburgh Medical Center, PA 15213-2582, USA.
Diagn Cytopathol. 1996 Mar;14(2):126-34. doi: 10.1002/(SICI)1097-0339(199603)14:2<126::AID-DC5>3.0.CO;2-H.
A retrospective review of 54 cases of adrenal gland needle biopsy in 53 patients is presented. The cases included 43 fine-needle aspirations (FNA), six core-needle biopsies, and five cases in which both types of needle biopsy were done. Clinical or histologic follow-up was available in 28 of the 36 specimens deemed adequate for evaluation. Metastatic malignancies represented the largest group of cases (19), with lung being the most common primary site (8). The series included four cases of metastatic hepatocellular carcinoma. Probable adrenocortical adenoma was the next most common diagnosis (12 cases). Cases causing diagnostic confusion included a case of metastatic well-differentiated hepatocellular carcinoma which was initially confused with an adrenocortical adenoma and a probable adrenocortical adenoma which was mistaken for a metastatic small round cell malignancy. (This case is unproved because of lack of clinical or histologic follow-up). By evaluating only those cases with histologic confirmation or clinical follow-up greater than one year, the sensitivity of needle biopsy for the presence of malignancy was 95% and the specificity was 100%. The cytologic findings are described with attention to the potential problem of confusing primary adrenocortical neoplasms with metastases from hepatocellular carcinoma.
本文对53例患者的54例肾上腺穿刺活检病例进行了回顾性研究。这些病例包括43例细针穿刺抽吸活检（FNA）、6例粗针活检以及5例同时进行了两种穿刺活检的病例。在36例被认为适合评估的标本中，有28例获得了临床或组织学随访结果。转移性恶性肿瘤是最大的病例组（19例），其中肺部是最常见的原发部位（8例）。该系列还包括4例转移性肝细胞癌。可能的肾上腺皮质腺瘤是第二常见的诊断结果（12例）。导致诊断混淆的病例包括1例转移性高分化肝细胞癌，最初被误诊为肾上腺皮质腺瘤；以及1例可能的肾上腺皮质腺瘤，被误诊为转移性小圆细胞恶性肿瘤。（由于缺乏临床或组织学随访，该病例未经证实）。仅对那些有组织学证实或临床随访超过一年的病例进行评估，穿刺活检对恶性肿瘤的敏感性为95%，特异性为100%。本文描述了细胞病理学检查结果，并关注了将原发性肾上腺皮质肿瘤与肝细胞癌转移灶相混淆的潜在问题。
