Publication year
2011Source
Lung Cancer, 73, 3, (2011), pp. 310-5ISSN
Publication type
Article / Letter to editor
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Organization
Pulmonary Diseases
Endocrinology
Nuclear Medicine
Pathology
Journal title
Lung Cancer
Volume
vol. 73
Issue
iss. 3
Page start
p. 310
Page end
p. 5
Subject
IGMD 6: Hormonal regulation; N4i 1: Pathogenesis and modulation of inflammation; N4i 3: Poverty-related infectious diseases ONCOL 5: Aetiology, screening and detection; ONCOL 3: Translational research; ONCOL 5: Aetiology, screening and detection; Internal Medicine - Radboud University Medical Center; Medical Imaging - Radboud University Medical CenterAbstract
In patients with lung cancer, enlarged or (18)Fluoro-deoxyglucose positron emission tomography ((18)FDG-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 (18)FDG-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 (18)FDG-PET positive adrenal glands. Therefore, EUS-FNA qualifies as the staging test of choice for patients with lung cancer with suspected left adrenal metastases.
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- Faculty of Medical Sciences [92283]
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