Incidentaloma other diagnostic studies: Difference between revisions
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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== | ||
*Fine-needle aspiration biopsy may be helpful in the diagnosis of incidentaloma. Findings diagnostic of incidentaloma include: | *[[Needle aspiration biopsy|Fine-needle aspiration biopsy]] may be helpful in the diagnosis of incidentaloma. Findings diagnostic of incidentaloma include: | ||
*It can distinguish between an | *It can distinguish between an [[Adrenal gland|adrena]]<nowiki/>l tumor and a [[Metastasis|metastatic]] tumor.<ref name="pmid19451490">{{cite journal| author=Mazzaglia PJ, Monchik JM| title=Limited value of adrenal biopsy in the evaluation of adrenal neoplasm: a decade of experience. | journal=Arch Surg | year= 2009 | volume= 144 | issue= 5 | pages= 465-70 | pmid=19451490 | doi=10.1001/archsurg.2009.59 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19451490 }}</ref> | ||
* In a patient with a known primary malignancy, performing a diagnostic CT-guided FNA biopsy may be indicated. | * In a patient with a known primary [[malignancy]], performing a diagnostic [[Computed tomography|CT]]-guided [[Needle aspiration biopsy|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.<ref name="pmid19958944">{{cite journal| author=Vanderveen KA, Thompson SM, Callstrom MR, Young WF, Grant CS, Farley DR et al.| title=Biopsy of pheochromocytomas and paragangliomas: potential for disaster. | journal=Surgery | year= 2009 | volume= 146 | issue= 6 | pages= 1158-66 | pmid=19958944 | doi=10.1016/j.surg.2009.09.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19958944 }}</ref> | * 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.<ref name="pmid19958944">{{cite journal| author=Vanderveen KA, Thompson SM, Callstrom MR, Young WF, Grant CS, Farley DR et al.| title=Biopsy of pheochromocytomas and paragangliomas: potential for disaster. | journal=Surgery | year= 2009 | volume= 146 | issue= 6 | pages= 1158-66 | pmid=19958944 | doi=10.1016/j.surg.2009.09.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19958944 }}</ref> | ||
* Adrenal biopsy would not be needed if the patient was already known to have a widespread 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 (FNA) biopsy '''cannot''' distinguish a benign adrenal mass from the less common adrenal carcinoma. | * [[Cytology]] from a specimen obtained by fine-needle aspiration ([[Needle aspiration biopsy|FNA]]) biopsy '''cannot''' distinguish a [[benign]] [[Adrenal gland|adrenal]] [[mass]] from the less common [[Adrenal gland|adrenal]] [[carcinoma]]. | ||
* 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> | ||
* The complications of this procedure include adrenal and liver hematoma, abdominal pain, hematuria, pancreatitis, pneumothorax, formation of an adrenal abscess, and tumor recurrence along the needle track.<ref name="pmid12574782">{{cite journal| author=Arellano RS, Harisinghani MG, Gervais DA, Hahn PF, Mueller PR| title=Image-guided percutaneous biopsy of the adrenal gland: review of indications, technique, and complications. | journal=Curr Probl Diagn Radiol | year= 2003 | volume= 32 | issue= 1 | pages= 3-10 | pmid=12574782 | doi=10.1067/cdr.2003.120002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574782 }}</ref> | * The complications of this procedure include adrenal and [[liver]] [[hematoma]], [[Abdominal pain|abdominal pain,]] [[Hematuria|hematuria,]] [[pancreatitis]], [[pneumothorax]], formation of an [[Adrenal gland|adrenal]] [[abscess]], and tumor recurrence along the needle track.<ref name="pmid12574782">{{cite journal| author=Arellano RS, Harisinghani MG, Gervais DA, Hahn PF, Mueller PR| title=Image-guided percutaneous biopsy of the adrenal gland: review of indications, technique, and complications. | journal=Curr Probl Diagn Radiol | year= 2003 | volume= 32 | issue= 1 | pages= 3-10 | pmid=12574782 | doi=10.1067/cdr.2003.120002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574782 }}</ref> | ||
==References== | ==References== | ||
Revision as of 18:07, 28 August 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. Findings diagnostic of incidentaloma include:
- 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.
- The FNA biopsy of a pheochromocytoma may result in hemorrhage and hypertensive crisis. So, excluding pheochromocytoma with biochemical testing is necessary before any procedure.[2]
- Adrenal biopsy would not be needed if the patient was already known to have a widespread metastatic disease.[3]
- Cytology from a specimen obtained by fine-needle aspiration (FNA) biopsy cannot 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.[4]
- The complications of this procedure include adrenal and liver hematoma, abdominal pain, hematuria, pancreatitis, pneumothorax, formation of an adrenal abscess, and tumor recurrence along the needle track.[5]
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.
- ↑ 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.
- ↑ 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.
- ↑ 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.