TY - JOUR
T1 - Fine-needle aspiration cytology of adrenal masses
T2 - A re-assessment with histological confirmation
AU - Tirabassi, G.
AU - Kola, B.
AU - Ferretti, M.
AU - Papa, R.
AU - Mancini, T.
AU - Mantero, F.
AU - Scarpelli, M.
AU - Boscaro, M.
AU - Arnaldi, G.
PY - 2012/6
Y1 - 2012/6
N2 - Background: Fine-needle aspiration (FNA) of adrenal masses is a method currently indicated in lesions suspected of being extra-adrenal in origin; even though its diagnostic reliability has already been determined in many studies, few have used histological examination obtained after adrenalectomy for diagnostic confirmation. Aim: To analyze the diagnostic performance of adrenal FNA in subjects with an available histological confirmation. Subjects and methods: Fifty subjects (26 benign adrenal lesions, 9 primary malignant lesions, and 15 metastatic lesions) who had undergone ultrasound (US)-guided adrenal FNA and then adrenalectomy were re-analyzed retrospectively. Results: FNA guaranteed a sensitivity of 85.7% and a specificity of 100% in all subjects; after having divided the subjects into oncologic and non-oncologic groups, the sensitivity of the test in oncologic patients (100%) increased significantly compared to non-oncologic (57.1%) with no difference in specificity (100% in both groups). Considering also non-diagnostic samples in our analysis (no.=11; 22% of all samples studied), FNA correctly diagnosed malignancy only in 75% of the cases and benignancy only in 66.6%; however, even after including nondiagnostic samples, the percentage of correct malignancy diagnosis remained significantly higher in oncologic (93.3%) than in non-oncologic patients (44.4%) without significant statistical difference between the 2 groups regarding the percentage of correct benignancy diagnosis (respectively 100% and 63.6%). Conclusions: Our study, based on histological confirmation, underlines the low discriminant value of US-guided adrenal FNA, though the method may have value in oncologic patients.
AB - Background: Fine-needle aspiration (FNA) of adrenal masses is a method currently indicated in lesions suspected of being extra-adrenal in origin; even though its diagnostic reliability has already been determined in many studies, few have used histological examination obtained after adrenalectomy for diagnostic confirmation. Aim: To analyze the diagnostic performance of adrenal FNA in subjects with an available histological confirmation. Subjects and methods: Fifty subjects (26 benign adrenal lesions, 9 primary malignant lesions, and 15 metastatic lesions) who had undergone ultrasound (US)-guided adrenal FNA and then adrenalectomy were re-analyzed retrospectively. Results: FNA guaranteed a sensitivity of 85.7% and a specificity of 100% in all subjects; after having divided the subjects into oncologic and non-oncologic groups, the sensitivity of the test in oncologic patients (100%) increased significantly compared to non-oncologic (57.1%) with no difference in specificity (100% in both groups). Considering also non-diagnostic samples in our analysis (no.=11; 22% of all samples studied), FNA correctly diagnosed malignancy only in 75% of the cases and benignancy only in 66.6%; however, even after including nondiagnostic samples, the percentage of correct malignancy diagnosis remained significantly higher in oncologic (93.3%) than in non-oncologic patients (44.4%) without significant statistical difference between the 2 groups regarding the percentage of correct benignancy diagnosis (respectively 100% and 63.6%). Conclusions: Our study, based on histological confirmation, underlines the low discriminant value of US-guided adrenal FNA, though the method may have value in oncologic patients.
KW - Adrenal glands
KW - Biopsy-needle
KW - Cancer
KW - Diagnosis
KW - Sensitivity and specificity
UR - http://www.scopus.com/inward/record.url?scp=84863958109&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84863958109&partnerID=8YFLogxK
U2 - 10.3275/8010
DO - 10.3275/8010
M3 - Article
C2 - 21979196
AN - SCOPUS:84863958109
VL - 35
SP - 590
EP - 594
JO - Journal of Endocrinological Investigation
JF - Journal of Endocrinological Investigation
SN - 0391-4097
IS - 6
ER -