Preoperative routine evaluation of bilateral adrenal glands by endoscopic ultrasound and fine-needle aspiration in patients with potentially resectable lung cancer

Endoscopy. 2013;45(3):195-201. doi: 10.1055/s-0032-1325988. Epub 2013 Jan 8.

Abstract

Background and study aims: The aim of the current study was to assess the detection rate of the right adrenal gland and the diagnostic ability of endoscopic ultrasound (EUS) and fine-needle aspiration (FNA) for the diagnosis of adrenal metastasis in potentially resectable lung cancer.

Patients and methods: This retrospective cohort study included a consecutive series of 150 patients undergoing EUS/EUS - FNA for staging of lung cancer. The detection rate of the right adrenal gland by EUS and the diagnostic accuracies of computed tomography (CT), positron emission tomography-CT (PET-CT), and EUS/EUS - FNA for the diagnosis of adrenal metastasis were evaluated.

Results: The right adrenal gland was visualized by EUS in 131 patients (87.3 %); the left adrenal gland was visualized in all patients. Findings suggestive of metastasis in either one of the adrenal glands or in both were observed in 6 patients (4.0 %) by CT, in 5 patients (3.3 %) by PET-CT, and in 11 patients (7.3 %) by EUS. EUS - FNA was performed simultaneously in the 11 patients, and in 4 patients the diagnosis of metastasis was established. The accuracy for the diagnosis of adrenal metastasis was 100 % for EUS/EUS - FNA, 96.0 % for CT, and 97.0 % for PET-CT (P = 0.1146).

Conclusions: As well as the left adrenal gland, the right adrenal gland was also usually visible by EUS. EUS/EUS - FNA provided an accurate diagnosis of adrenal metastasis, although the prevalence of adrenal metastasis was relatively low in these patients with potentially resectable lung cancer.

Publication types

  • Video-Audio Media

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / secondary
  • Adrenal Gland Neoplasms / diagnosis*
  • Adrenal Gland Neoplasms / secondary
  • Adrenal Glands / diagnostic imaging
  • Adrenal Glands / pathology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration*
  • Endosonography
  • Female
  • Humans
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Positron-Emission Tomography
  • Preoperative Care
  • Retrospective Studies
  • Small Cell Lung Carcinoma / diagnosis*
  • Small Cell Lung Carcinoma / secondary
  • Tomography, X-Ray Computed