Endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration of the left adrenal gland☆,☆☆,★
Section snippets
METHODS
EUS was performed in 31 consecutive patients for various indications (diagnosis and staging of gastrointestinal and lung malignancies). Of the patients in whom a final diagnosis was known by surgery or 6-month follow-up, 9 of 23 had benign lesions and 14 of 23 had malignant lesions. The left adrenal was specifically searched for in all patients. There were 11 male and 20 female patients with ages ranging from 38 to 92 years. EUS was done using the Olympus GF-UM20 echoendoscope (Olympus America
RESULTS
The left adrenal gland was detected and characterized in 30 of 31 (97%) patients. In one patient, the adrenal gland was not identified.
The echoendoscope was advanced through the esophagus into the proximal stomach. The abdominal aorta was first identified just below the gastroesophageal junction. The splenic vein was then isolated by advancing the transducer forward with a clockwise rotation. The splenic hilum was found by following the splenic vein laterally (further clockwise rotation and
DISCUSSION
The application of EUS in imaging the adrenal gland has not been described. Previously in our experience, if the adrenal was imaged, it was an incidental finding of no clinical significance. However, now that EUS may play a role in the lymph node staging of lung cancer (and adrenal metastasis occurs not infrequently), imaging the adrenal may have a clinical application.
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2017, Lung CancerCitation Excerpt :However, false positive CT, MRI [17] and FDG-PET-CT [18,19] findings for malignant involvement occur, underscoring the need for tissue proof of a suspected LAG. Conventional EUS-FNA is a well-established technique to evaluate the LAG, and previous studies have shown that it can identify the LAG in up to 97% of cases [20,21]. Previous studies have also shown that sensitivity and NPV of EUS-FNA for detection of LAG metastases of primary lung cancer are at least 86% and 70%, respectively [22].
Clinical Aspects of Lung Cancer
2015, Murray and Nadel's Textbook of Respiratory Medicine: Volume 1,2, Sixth EditionEndosonographic Evaluation of the Adrenal Glands: Part I
2013, Video Journal and Encyclopedia of GI Endoscopy
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From the Division of Gastroenterology, University of California, Irvine Medical Center, Orange, and the VA Medical Center, Long Beach, California.
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Reprint requests: Kenneth J. Chang, MD, UCI Clinical Cancer Center, 101 The City Drive, Bldg 23, Rm 330, Orange, CA 92668.
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