Journal
LUNG CANCER
Volume 73, Issue 3, Pages 310-315Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.lungcan.2010.12.019
Keywords
Lung cancer; EUS-FNA; Left adrenal metastasis; Staging; (18)FDG-PET-CT; Left adrenal gland; Ultrasound
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In patients with lung cancer, enlarged or (18)Fluoro-deoxyglucose positron emission tomography ((8)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. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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