EUS-FNA for the detection of left adrenal metastasis in patients with lung cancer

Summary In patients with lung cancer, enlarged or18 Fluoro-deoxyglucose positron emission tomography (18 FDG-PET) positive left adrenal glands are suspected for distant metastases and require tissue confirmation for a definitive assessment. The aim of this study was to assess the sensitivity of endo...

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Published in:Lung cancer (Amsterdam, Netherlands) Vol. 73; no. 3; pp. 310 - 315
Main Authors: Schuurbiers, Olga C.J, Tournoy, Kurt G, Schoppers, Hans J, Dijkman, Bernadette G, Timmers, Henri J.L.M, de Geus-Oei, Lioe-Fee, Grefte, Johanna M.M, Rabe, Klaus F, Dekhuijzen, P.N. Richard, van der Heijden, Henricus F.M, Annema, Jouke T
Format: Journal Article
Language:English
Published: Oxford Elsevier Ireland Ltd 01-09-2011
Elsevier
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Summary:Summary In patients with lung cancer, enlarged or18 Fluoro-deoxyglucose positron emission tomography (18 FDG-PET) positive left adrenal glands are suspected for distant metastases and require tissue confirmation for a definitive assessment. The aim of this study was to assess the sensitivity of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for left adrenal metastases in lung cancer patients with a suspect adrenal gland based on imaging. EUS-FNA findings of patients with (suspected) lung cancer and CT enlarged or18 FDG-PET positive left adrenal glands were retrospectively evaluated. In the absence of metastases at EUS, clinical and radiological follow-up was obtained. In 85 patients, EUS-FNA demonstrated left adrenal metastases of lung cancer in 53 (62%), benign adrenal tissue in 25 (29%), a metastasis from colon carcinoma in 1 (1%) and a primary adrenocortical carcinoma in 1 (1%) patient. In five patients (5.9%), the aspirates contained non-representative material. EUS outcomes were false negative in two patients. Sensitivity and negative predictive value (NPV) for EUS-FNA of the left adrenal gland were at least 86% (95% CI 74–93%) and 70% (95% CI 50–85%). No complications occurred. EUS-FNA is a sensitive, safe and minimally invasive technique to provide tissue proof of left adrenal metastases in patients with (suspected) lung cancer and enlarged or18 FDG-PET positive adrenal glands. Therefore, EUS-FNA qualifies as the staging test of choice for patients with lung cancer with suspected left adrenal metastases.
ISSN:0169-5002
1872-8332
DOI:10.1016/j.lungcan.2010.12.019