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

2011; Elsevier BV; Volume: 73; Issue: 3 Linguagem: Inglês

10.1016/j.lungcan.2010.12.019

1872-8332

Olga C.J. Schuurbiers, Kurt G. Tournoy, Hans J. Schoppers, Bernadette G Dijkman, Henri Timmers, Lioe‐Fee de Geus‐Oei, Johanna M. M. Grefte, Klaus F. Rabe, P.N.R. Dekhuijzen, Erik H.F.M. van der Heijden, Jouke T. Annema,

Cardiac tumors and thrombi

In patients with lung cancer, enlarged or 18Fluoro-deoxyglucose positron emission tomography (18FDG-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 or 18FDG-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 or 18FDG-PET positive adrenal glands. Therefore, EUS-FNA qualifies as the staging test of choice for patients with lung cancer with suspected left adrenal metastases.