Predictive Value of Benign Percutaneous Adrenal Biopsies in Oncology Patients

PURPOSE: Percutaneous CT guided biopsy is accepted as a safe procedure for the diagnosis of indeterminate adrenal masses in oncologic patients. The purpose of this study was to evaluate the accuracy of a ‘negative for tumour’ adrenal biopsy in the oncologic patient population by assessing subsequent...

Full description

Saved in:
Bibliographic Details
Published in:Clinical radiology 2002-10, Vol.57 (10), p.898-901
Main Authors: Harisinghani, M.G, Maher, M.M, Hahn, P.F, Gervais, D.A, Jhaveri, K, Varghese, J, Mueller, P.R
Format: Article
Language:English
Subjects:
Adenoma - diagnostic imaging
Adenoma - pathology
Adrenal Gland Neoplasms - diagnostic imaging
Adrenal Gland Neoplasms - pathology
Adrenal Gland Neoplasms - secondary
adrenal gland, biopsies, interventional procedures
Adrenal Glands - diagnostic imaging
Adrenal Glands - pathology
Adult
Aged
Aged, 80 and over
Biopsy, Needle - methods
Biopsy, Needle - standards
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Radiography, Interventional
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed - methods
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:PURPOSE: Percutaneous CT guided biopsy is accepted as a safe procedure for the diagnosis of indeterminate adrenal masses in oncologic patients. The purpose of this study was to evaluate the accuracy of a ‘negative for tumour’ adrenal biopsy in the oncologic patient population by assessing subsequent outcome including clinical course, size and imaging characteristics of the adrenal lesions on follow-up imaging studies and pathological findings at re-biopsy or following adrenal mass resection. MATERIALS AND METHODS: Retrospective analysis of 225 oncological patients (FM, 128;87; age range 33–87 years, mean age 66 years) who had undergone CT guided biopsies of an adrenal mass over a 5-year period was performed. Those patients with a report consistent with ‘negative for malignancy’ were evaluated by reviewing the medical records for patient demographics, primary malignancy, histology of adrenal tumour, subsequent surgical interventions, repeat adrenal biopsy under image guidance, by open surgery or at autopsy, subsequent abdominal imaging in which the adrenal gland was imaged, and long-term outcome including hospital admissions, or death. RESULTS: Of the 225 CT-guided adrenal biopsies performed, 41 (18%) were negative for neoplasm. The primary neoplasm in these 41 patients included lung cancer (n=32), breast (n=5), renal cell carcinoma (n=2), bladder (n=1), and prostate (n=1). The size of the adrenal lesions ranged from 2.8–5cm. Of the 41 biopsies, which were negative for tumour; 10 were identified as adenomas and the rest showed benign adrenal cortical cells or hyperplasia on cytopathology and histopathology. Repeat biopsies were obtained in 13/41 (31%) patients; whereas 2/41 (5%) had their adrenal gland analyzed on post mortem examination. None of these 15 repeat evaluations yielded tumour. CONCLUSION: In oncological patients, pathological analysis of tissue samples obtained by CT-guided percutaneous biopsy, suggesting benign aetiology, is reliable and predicts a benign course on long-term follow-up. A negative or benign pathology result for a CT guided percutaneous adrenal biopsy can be regarded as a true negative evaluation in oncological patients with no necessity to repeat the biopsy. Harisinghani M. G. et al. (2002) Clinical Radiology,57, 898–901.
ISSN:0009-9260
1365-229X
DOI:10.1053/crad.2002.1054