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==Overview== | ==Overview== | ||
[[Needle aspiration biopsy|Fine-needle aspiration biopsy]] may be helpful in the diagnosis of incidentaloma. It can distinguish between an [[Adrenal gland|adrena]]<nowiki/>l tumor and a [[Metastasis|metastatic]] tumor. In a patient with a known primary [[malignancy]], performing a diagnostic [[Computed tomography|CT]]-guided [[Needle aspiration biopsy|FNA]] biopsy may be indicated. The [[Needle aspiration biopsy|FNA]] biopsy of a [[pheochromocytoma]] may result in [[hemorrhage]] and [[hypertensive crisis]]. So, excluding [[pheochromocytoma]] with biochemical testing is necessary before any procedure. | |||
==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
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* [[Adrenal gland|Adrenal]] [[biopsy]] would not be needed if the patient was already known to have a widespread [[Metastasis|metastatic]] disease.<ref name="pmid15376200">{{cite journal| author=Jhala NC, Jhala D, Eloubeidi MA, Chhieng DC, Crowe DR, Roberson J et al.| title=Endoscopic ultrasound-guided fine-needle aspiration biopsy of the adrenal glands: analysis of 24 patients. | journal=Cancer | year= 2004 | volume= 102 | issue= 5 | pages= 308-14 | pmid=15376200 | doi=10.1002/cncr.20498 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15376200 }}</ref> | * [[Adrenal gland|Adrenal]] [[biopsy]] would not be needed if the patient was already known to have a widespread [[Metastasis|metastatic]] disease.<ref name="pmid15376200">{{cite journal| author=Jhala NC, Jhala D, Eloubeidi MA, Chhieng DC, Crowe DR, Roberson J et al.| title=Endoscopic ultrasound-guided fine-needle aspiration biopsy of the adrenal glands: analysis of 24 patients. | journal=Cancer | year= 2004 | volume= 102 | issue= 5 | pages= 308-14 | pmid=15376200 | doi=10.1002/cncr.20498 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15376200 }}</ref> | ||
* [[Cytology]] from a specimen obtained by fine-needle aspiration ([[Needle aspiration biopsy|FNA]]) | * [[Cytology]] from a specimen obtained by fine-needle aspiration ([[Needle aspiration biopsy|FNA]]) biopsy can not distinguish a [[benign]] [[Adrenal gland|adrenal]] [[mass]] from the less common [[Adrenal gland|adrenal]] [[carcinoma]]. | ||
* [[Needle aspiration biopsy|FNA]] biopsy is not useful in the routine evaluation of incidentalomas in patients suspected to have small non-adrenal cancers.<ref name="pmid26956774">{{cite journal| author=Kumar R, Dey P| title=Fine-needle aspiration cytology of non-neoplastic adrenal pathology. | journal=Diagn Cytopathol | year= 2016 | volume= 44 | issue= 6 | pages= 472-6 | pmid=26956774 | doi=10.1002/dc.23467 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26956774 }}</ref> | * [[Needle aspiration biopsy|FNA]] biopsy is not useful in the routine evaluation of incidentalomas in patients suspected to have small non-adrenal cancers.<ref name="pmid26956774">{{cite journal| author=Kumar R, Dey P| title=Fine-needle aspiration cytology of non-neoplastic adrenal pathology. | journal=Diagn Cytopathol | year= 2016 | volume= 44 | issue= 6 | pages= 472-6 | pmid=26956774 | doi=10.1002/dc.23467 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26956774 }}</ref> | ||
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** [[Pneumothorax]] | ** [[Pneumothorax]] | ||
** [[Adrenal gland|Adrenal]] [[abscess]] | ** [[Adrenal gland|Adrenal]] [[abscess]] | ||
** Tumor recurrence along the needle track | ** [[Tumor]] recurrence along the needle track | ||
==References== | ==References== | ||
Revision as of 16:03, 9 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
Fine-needle aspiration biopsy may be helpful in the diagnosis of incidentaloma. It can distinguish between an adrenal tumor and a metastatic tumor. In a patient with a known primary malignancy, performing a diagnostic CT-guided FNA biopsy may be indicated. The FNA biopsy of a pheochromocytoma may result in hemorrhage and hypertensive crisis. So, excluding pheochromocytoma with biochemical testing is necessary before any procedure.
Other Diagnostic Studies
- Fine-needle aspiration biopsy may be helpful in the diagnosis of incidentaloma. It can distinguish between an adrenal tumor and a metastatic tumor.[1]
- In a patient with a known primary malignancy, performing a diagnostic CT-guided FNA biopsy may be indicated.
- Adrenal biopsy would not be needed if the patient was already known to have a widespread metastatic disease.[2]
- Cytology from a specimen obtained by fine-needle aspiration (FNA) biopsy can not distinguish a benign adrenal mass from the less common adrenal carcinoma.
- FNA biopsy is not useful in the routine evaluation of incidentalomas in patients suspected to have small non-adrenal cancers.[3]
- The FNA biopsy of a pheochromocytoma may result in hemorrhage and hypertensive crisis. So, excluding pheochromocytoma with biochemical testing is necessary before any procedure.[4]
- The complications of FNAC include:[5]
- Adrenal and liver hematoma
- Abdominal pain
- Hematuria
- Pancreatitis
- Pneumothorax
- Adrenal abscess
- Tumor recurrence along the needle track
References
- ↑ Mazzaglia PJ, Monchik JM (2009). "Limited value of adrenal biopsy in the evaluation of adrenal neoplasm: a decade of experience". Arch Surg. 144 (5): 465–70. doi:10.1001/archsurg.2009.59. PMID 19451490.
- ↑ Jhala NC, Jhala D, Eloubeidi MA, Chhieng DC, Crowe DR, Roberson J; et al. (2004). "Endoscopic ultrasound-guided fine-needle aspiration biopsy of the adrenal glands: analysis of 24 patients". Cancer. 102 (5): 308–14. doi:10.1002/cncr.20498. PMID 15376200.
- ↑ Kumar R, Dey P (2016). "Fine-needle aspiration cytology of non-neoplastic adrenal pathology". Diagn Cytopathol. 44 (6): 472–6. doi:10.1002/dc.23467. PMID 26956774.
- ↑ Vanderveen KA, Thompson SM, Callstrom MR, Young WF, Grant CS, Farley DR; et al. (2009). "Biopsy of pheochromocytomas and paragangliomas: potential for disaster". Surgery. 146 (6): 1158–66. doi:10.1016/j.surg.2009.09.013. PMID 19958944.
- ↑ Arellano RS, Harisinghani MG, Gervais DA, Hahn PF, Mueller PR (2003). "Image-guided percutaneous biopsy of the adrenal gland: review of indications, technique, and complications". Curr Probl Diagn Radiol. 32 (1): 3–10. doi:10.1067/cdr.2003.120002. PMID 12574782.