Cytologic Evaluation as a Diagnostic Tool to Differentiate Adrenocortical Tumors and Pheochromocytomas

Abstract

Background

The utility of cytologic evaluation to distinguish adrenocortical tumors and pheochromocytomas in dogs has not been thoroughly investigated, partly because of the perceived risks of the procedure.

Objectives

Report test characteristics of fine needle aspiration (FNA) and cytologic evaluation for differentiation of adrenocortical tumors and pheochromocytomas in dogs. Complications associated with FNA also were recorded.

Animals

Thirty-eight dogs with 40 adrenal tumors that had FNA and cytologic evaluation performed before adrenalectomy were included in the study from three institutions. Tumors included 17 pheochromocytomas, 21 adrenocortical tumors, 1 concurrent adrenocortical adenoma and pheochromocytoma, and 1 malignant neoplasm.

Results

Of the 40 FNA cytologic aspirations performed, 35 (87.5%) had a predominant cell type identified and therefore were considered of diagnostic quality. Of these, 30 (85.7%) correlated with the final histopathological diagnosis. When all samples were included, FNA and cytologic evaluation had a sensitivity of 77.3%, specificity of 76.5%, positive predictive value of 81.0%, negative predictive value of 72.2%, and accuracy of 76.9% for identifying adrenocortical tumors. For pheochromocytomas, these values were 72.2%, 95.2%, 92.8%, 80.0%, and 84.5%, respectively. Six (15.9%) dogs had self-limiting complications associated with the FNA procedure.

Conclusion and Clinical Importance

Fine needle aspiration and cytologic evaluation of adrenal tumors has a low complication rate and can help differentiate adrenocortical tumors and pheochromocytomas. Thus, cytologic evaluation of adrenal tumors should be considered to help differentiate adrenal tumors and allow more individualized treatment of affected dogs.