Incidentaloma other diagnostic studies
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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 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.
- ↑ 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.